硒酵母片联合左甲状腺素钠治疗甲状腺功能减退症的临床效果

李山+姜旻+王芬

[摘要] 目的 探討硒酵母片联合左甲状腺素钠治疗甲状腺功能减退症的临床效果。 方法 选择2015年4月～2016年4月在北京中医药大学第三附属医院接受治疗的甲状腺功能减退症患者80例作为研究对象，并按照随机、双盲、对照的原则将其分为对照组和试验组，每组各40例。对照组采用口服左甲状腺素钠联合安慰剂治疗，试验组在口服左甲状腺素钠治疗基础上联合口服硒酵母片治疗，两组均治疗6个月。比较两组临床疗效，促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离四碘甲状腺原氨酸（FT4），不良反应发生情况及患者满意度。 结果 治疗后试验组总有效率高于对照组，差异有统计学意义（P < 0.05）。用药后两组TSH均明显低于用药前，FT3和FT4高于用药前，试验组改善更为显著，差异均有统计学意义（P < 0.05）。两组不良反应发生率比较，差异无统计学意义（P > 0.05）。试验组总满意度高于对照组，差异有统计学意义（P < 0.05）。 结论 硒酵母片联合左甲状腺素钠有助于控制甲状腺功能减退症患者的临床症状，改善体内激素水平，提高患者满意度，安全性高，值得推广应用。

[关键词] 甲状腺功能减退症；左甲状腺素钠片；硒酵母片；甲状腺功能；临床疗效

[中图分类号] R581.2 [文献标识码] A [文章编号] 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