论文部分内容阅读
目的:探讨小剂量糖皮质激素联合消炎痛治疗亚急性甲状腺炎(Subacute thyroiditis,ST)的临床效果及安全性。方法:选取我院内分泌科2012年6月-2014年7月收治的150例亚急性甲状腺炎患者,按照随机平均原则即药物治疗的不同将其分为三组,每组50例,即泼尼松与消炎痛联合治疗(A组)、泼尼松单独治疗(B组)、消炎痛单独治疗(C组),对比并分析三组的治疗效果,包括甲状腺疼痛和肿大平均消失时间,治疗1周的ESR平均水平,治疗4周后的血清TSH、FT3、FT4水平,并通过随访,观察治疗后8周患者不良反应的发生率、复发率。结果:(1)A组患者甲状腺疼痛和甲状腺肿大的消失时间与B组比较无显著差异(P>0.05),A、B组均显著短于C组(P<0.05)。A组患者治疗后1周、4周的ESR水平与B组对比差异不明显,无统计学意义(P>0.05);A、B组患者治疗后1周的ESR水平明显低于C组(P<0.05)。A、B组治疗后的血清TSH、FT3、FT4水平改善程度均优于C组,差异有统计学意义(P<0.05)。(2)A组、C组的不良反应发生率、复发率均低于B组,差异具有统计学意义(P<0.05)。结论:采用小剂量糖皮质激素联合消炎痛治疗亚急性甲状腺炎的临床效果显著,且不良反应和复发情况少。
Objective: To investigate the clinical effect and safety of low dose glucocorticoid combined with indomethacin in the treatment of subacute thyroiditis (ST). Methods: A total of 150 subacute thyroiditis patients admitted to Department of Endocrinology of our hospital from June 2012 to July 2014 were divided into three groups according to the randomized average principle: drug treatment. 50 cases in each group were prednisone (Group A), prednisone alone (group B) and indomethacin alone (group C). The therapeutic effects of three groups were compared and analyzed, including the time to the complete disappearance of thyroid pain and swelling, 1 week ESR level, serum TSH, FT3, FT4 levels after 4 weeks of treatment. The incidence of adverse reactions and the recurrence rate were observed after 8 weeks of follow-up. Results: (1) The disappearance time of thyroid pain and goiter in group A was not significantly different from that in group B (P> 0.05), but was significantly shorter in group A and B than that in group C (P <0.05). There was no significant difference in ESR between group A and group B after 1 and 4 weeks of treatment (P> 0.05). The level of ESR in group A and group B after 1 week of treatment was significantly lower than that of group C <0.05). The levels of serum TSH, FT3 and FT4 in group A and group B were better than those in group C, the difference was statistically significant (P <0.05). (2) The incidences of adverse reaction and recurrence in group A and group C were lower than those in group B, the difference was statistically significant (P <0.05). Conclusion: The clinical effect of using low dose glucocorticoids combined with indomethacin in the treatment of subacute thyroiditis is significant, and there are few adverse reactions and recurrences.