药物综合疗法治疗50例甲状腺功能亢进合并糖尿病患者临床效果研究

Clinical effects of combination therapy for 50 cases of hyperthyroidism patients with diabetes mellitus

目的探讨药物综合疗法治疗甲状腺功能亢进合并糖尿病患者的临床效果。方法将50例甲状腺功能亢进合并糖尿病患者分成治疗组和对照组,各25例,治疗组采用综合疗法,即先使用口服甲巯咪唑片进行甲亢的治疗,具体剂量:开始剂量30 mg/d,分次口服,每日维持量按病情需要介于5～15 mg,病情控制后,逐渐减量,同时使用胰岛素泵(丹纳Ⅱs)皮下持续注射胰岛素治疗;对照组患者一直使用口服降糖药进行常规治疗。密切观察并测量两组患者治疗前后的血糖水平以及甲亢症状的临床改善时间。结果治疗组治疗的总有效率(96.0%)明显高于对照组(64.0%),两组比较差异有统计学意义(χ2=8.1806,P=0.0167),治疗组患者的空腹、早餐后2 h、午餐前、午餐后2 h、晚餐前及晚餐后2 h的血糖水平明显低于对照组,两组比较差异有高度统计学意义(P<0.01)。治疗组甲亢症状的临床改善时间为(6.1±0.8)d;对照组组甲亢症状的临床改善时间为(9.3±1.1)d,两组比较差异有统计学意义(t=11.7634,P=0.0000)。结论本课题组采用综合疗法治疗甲状腺功能亢进合并糖尿病患者效果可靠,值得推广。

Objective To investigate the clinical effects of combination therapy for hyperthyroid patients with diabetes.Methods 50 cases of hyperthyroidism and diabetes patients were divided into treatment group and control group,with 25 cases in each group.The treatment group was treated with combination therapy for the first use of oral Methimazole Tablets for the treatment of hyperthyroidism,specifically dose： starting dose of 30 mg/d,sub-sub-oral daily mainte nance dose according to patient＇s condition needs to be between 5-15 mg,disease control,the gradual reduction,while an insulin pump（Dana Ⅱ s） continuous subcutaneous insulin therapy were used;the control group was used oral hy poglycemic agents for routine treatment.Before and after treatment of blood glucose levels and clinical symptoms of hyperthyroidism improved time were observed and measured.Results The total effective rate（96.0%） of treatment group was significantly higher than control group（64.0%）,the difference of the two groups was statistically significant（χ^2=8.1806,P = 0.0167）,fasting,after breakfast,2 h,before lunch after lunch,2 h,2 h before dinner and after dinner blood glucose levels of the treatment group were significantly lower than the control group,the differences of the two groups were statistically significant（P〈0.01）.The clinical symptoms of hyperthyroidism improved time of the treat ment group was（6.1±0.8） d;the clinical improvement in symptoms of hyperthyroidism time of the control group was（9.3±1.1） d,the difference was statistically significant（t = 11.7634,P = 0.0000）.Conclusion Our group uses combination therapy in patients with hyperthyroidism and diabetes and achieves an effective and reliable efficacy,which is worthy of promotion.