硒酵母片聯合左甲狀腺素鈉治療甲狀腺功能減退癥的臨床效果

李山+姜旻+王芬

[摘要] 目的 探討硒酵母片聯合左甲狀腺素鈉治療甲狀腺功能減退癥的臨床效果。 方法 選擇2015年4月～2016年4月在北京中醫藥大學第三附屬醫院接受治療的甲狀腺功能減退癥患者80例作為研究對象，并按照隨機、雙盲、對照的原則將其分為對照組和試驗組，每組各40例。對照組采用口服左甲狀腺素鈉聯合安慰劑治療，試驗組在口服左甲狀腺素鈉治療基礎上聯合口服硒酵母片治療，兩組均治療6個月。比較兩組臨床療效，促甲狀腺激素（TSH）、游離三碘甲狀腺原氨酸（FT3）和游離四碘甲狀腺原氨酸（FT4），不良反應發生情況及患者滿意度。 結果 治療后試驗組總有效率高于對照組，差異有統計學意義（P < 0.05）。用藥后兩組TSH均明顯低于用藥前，FT3和FT4高于用藥前，試驗組改善更為顯著，差異均有統計學意義（P < 0.05）。兩組不良反應發生率比較，差異無統計學意義（P > 0.05）。試驗組總滿意度高于對照組，差異有統計學意義（P < 0.05）。 結論 硒酵母片聯合左甲狀腺素鈉有助于控制甲狀腺功能減退癥患者的臨床癥狀，改善體內激素水平，提高患者滿意度，安全性高，值得推廣應用。

[關鍵詞] 甲狀腺功能減退癥；左甲狀腺素鈉片；硒酵母片；甲狀腺功能；臨床療效

[中圖分類號] R581.2 [文獻標識碼] A [文章編號] 1673-7210（2018）01（c）-0052-04

[Abstract] Objective To explore the clinical effects of Selenious yeast tablets combined with Levothyroxine sodium in the treatment of hypothyroidism. Methods From April 2015 to April 2016， 80 cases of patients with hypothyroidism treated in Beijing University of Chinese Medicine Third Affiliated Hospital were selected as research objects and divided into the control group and the experimental group by random， double-blind and control method， with 40 cases in each group. The control group was treated with oral Levothyroxine sodium combined with placebo and the experimental group was treated with oral Selenious yeast tablets on the basis of Levothyroxine sodium. Both groups were treated for 6 months. The clinical efficacy， the levels of thyroid stimulating hormone （TSH）， free triiodothyronine （FT3） and free tetraiodothyronine （FT4）， the adverse reactions and the patiens′ satisfaction in the two groups were compared. Results After treatment， the incidence of clinical efficacy in the experimental group was higher than that of control group， with statistically significant difference （P < 0.05）. After treatment， the TSH was lower， the FT3 and FT4 were higher than those of before treatment in the two groups， the indicators above in the experimental group improved much more remarkably， with statistically significant differences （P < 0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P > 0.05）. The patiens′ satisfaction in the experimental group was higher than that of control group， with statistically significant difference （P < 0.05）. Conclusion Selenious yeast tablets combined with Levothyroxine sodium is helpful to control the clinical symptoms in patients with hypothyroidism. It can improve the levels of thyroid hormone， promote the patiens′ satisfactton and has high safty. It is worthy of promotion and application.endprint