Graves病药物治疗维持期不同周期方案疗效研究

Study on Efficacy of Different Cycle Regimens of Drug Treatment in the Treatment of Graves’ diseases During Maintenance Period

目的:探讨Graves病(GD)口服抗甲状腺药物治疗维持期合理方案。方法:选取2012年8月—2015年8月我院收治的GD患者480例为研究对象,随机配对分配至A、B、C、D组,各120例。各组常规给予丙硫氧嘧啶(PTU)治疗,维持期25 mg口服,qd,维持期方案A、B、C、D四组分别为周期1月、3月、6月、1年。比较四组治愈率、甲亢复发率、甲减发生率、变异率。结果:480例患者,完成446例。B、C、D组痊愈率高于A组,差异有统计学意义(P<0.05);B、C、D组甲亢复发率均低于A组,差异有统计学意义(P<0.05);B、C组变异率小于A、D组,差异有统计学意义(P<0.05);各组间甲减发生率、副作用发生率比较差异无统计学意义(P>0.05)。结论:PTU治疗GD过程中,维持周期方案以3月、6月为合理方案。

Objective:To explore a reasonable treatment regimen of oral antithyroid drugs for treating Graves’disease(GD)during the maintenance period.Methods:480 patients with GD admitted to our hospital from August 2012 to August 2015 were selected as subjects investigated,and they were randomly assigned to four groups:A,B,C and D,120 cases each.The patients in the four groups were given conventional treatment with propylthiouracil(PTU)(25 mg during the maintenance period,oral administration,qd),and the cycles for the regimens of the groups A,B,C and D during the maintenance period were 1 month,3 months,6 months and 1 year.The cure rate,the recurrence rate of hyperthyroidism,the incidence of hypothyroidism and the rate of mutation in the four groups were compared.Results:Of 480 patients,446 patients completed the treatment.The cure rate in the groups B,C and D was higher than that in the group A,with statistically significant differences(P<0.05).The recurrence rate of hyperthyroidism in the groups B,C and D was lower than that in the group A,with statistically significant differences(P<0.05).The rate of mutation in the groups B and C was lower than that in the groups A and D,with statistically significant differences(P<0.05).There were no statistically significant differences in the incidence of hypothyroidism and side effects among groups(P>0.05).Conclusion:During the treatment of GD with PTU,the reasonable maintenance cycle regimens are 3 months and 6 months.