李山+姜旻+王芬

[摘要] 目的 探討硒酵母片聯(lián)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(yī)藥大學(xué)第三附屬醫(yī)院接受治療的甲狀腺功能減退癥患者80例作為研究對(duì)象，并按照隨機(jī)、雙盲、對(duì)照的原則將其分為對(duì)照組和試驗(yàn)組，每組各40例。對(duì)照組采用口服左甲狀腺素鈉聯(lián)合安慰劑治療，試驗(yàn)組在口服左甲狀腺素鈉治療基礎(chǔ)上聯(lián)合口服硒酵母片治療，兩組均治療6個(gè)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(yīng)發(fā)生情況及患者滿(mǎn)意度。 結(jié)果 治療后試驗(yàn)組總有效率高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。用藥后兩組TSH均明顯低于用藥前，F(xiàn)T3和FT4高于用藥前，試驗(yàn)組改善更為顯著，差異均有統(tǒng)計(jì)學(xué)意義（P < 0.05）。兩組不良反應(yīng)發(fā)生率比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P > 0.05）。試驗(yàn)組總滿(mǎn)意度高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。 結(jié)論 硒酵母片聯(lián)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(nèi)激素水平，提高患者滿(mǎn)意度，安全性高，值得推廣應(yīng)用。

[關(guān)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(lèi)號(hào)] R581.2 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 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