泼尼松联合吲哚美辛治疗亚急性甲状腺炎效果观察

Effects of prednisone combined with indomethacin in the treatment of patients with subacute thyroiditis

目的 探讨泼尼松联合吲哚美辛在亚急性甲状腺炎治疗中的应用效果.方法 选取烟台市烟台山医院2015年1月至2017年1月收治的亚急性甲状腺炎患者140例为观察对象,采用随机数字表法分为观察组70例、对照组70例,两组患者均给予泼尼松治疗,观察组在对照组基础上联合吲哚美辛治疗,比较两组发热消退时间、甲状腺肿大消退时间、甲状腺疼痛消退时间、红细胞沉降率(ESR)、甲状腺激素、不良反应及复发情况.结果 观察组发热消退时间、甲状腺肿大消退时间、疼痛消退时间分别为(1.65 ± 0.89)d、(2.54 ± 0.92)d、(7.63 ± 1.57)d,均短于对照组的(2.07 ± 1.03)d、(2.96 ± 1.35)d、(8.45 ± 1.84)d,差异均有统计学意义(t=2.581、2.151、2.836,均P<0.05).治疗后,观察组ESR、促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)分别为(9.35 ± 4.17)mm/h、(2.53 ± 2.07)μU/L、(5.37 ± 2.81)pmol/L、(14.26 ± 2.54)pmol/L,对照组分别为(9.67 ± 4.26)mm/h、(2.45 ± 1.84)μU/L、(5.49 ± 2.23)pmol/L、(14.85 ± 3.27)pmol/L,两组差异均无统计学意义(均P>0.05).观察组发生不良反应6例(8.57%),对照组发生不良反应15例(21.42%),两组不良反应发生率差异有统计学意义(χ^2 =4.538,P<0.05).两组患者均随访6个月,观察组6例(8.57%)复发,对照组7例(10.00%)复发,两组复发率差异无统计学意义(χ^2 =0.085,P>0.05).结论 泼尼松联合吲哚美辛治疗亚急性甲状腺炎与单用泼尼松治疗效果相近,但在改善患者发热、疼痛及肿大等症状方面速度较快,安全性更好.

Objective To investigate the application effects of prednisone combined with indomethacin in the treatment of patients with subacute thyroiditis.Methods From January 2015 to January 2017,140 patients with subacute thyroiditis in Yantai Mountain Hospitalwere chosen in this research,and they were randomly divided into control group and research group according to the digital table,with 70 cases in each group.Both two groups were treated with prednisone,the research group was given indomethacin on this basis.The time of fever extinction,the time of goiter subside,the time of thyroid ache extinction,ESR,thyroid hormone,adverse reaction and recurrence of the two groups were compared.Results The time of fever extinction,the time of goiter subside,the time of thyroid ache extinction of the research group were(1.65 ± 0.89)d,(2.54 ± 0.92)d,(7.63 ± 1.57)d,which were all shorter than those of the control group [(2.07 ± 1.03)d,(2.96 ± 1.35)d,(8.45 ± 1.84)d],the differences were statistically significant(t=2.581,2.151,2.836,all P <0.05).After treatmnet,ESR,TSH,FT3,FT4 of the research group were(9.35 ± 4.17)mm/h,(2.53 ± 2.07)μU/L,(5.37 ± 2.81)pmol/L,(14.26 ± 2.54)pmol/L,respectively,which of the control group were(9.67 ± 4.26)mm/h,(2.45 ± 1.84)μU/L,(5.49 ± 2.23)pmol/L,(14.85 ± 3.27)pmol/L,respectively,there were no statistically significant differences between the two groups(all P >0.05).There were 6 cases(8.57%)occurred adverse reaction in the research group,and 15 cases(21.42%)in the control group,the difference was statistically significant(χ^2 =4.538,P<0.05).All the patients were followed up for 6 months,6 cases(8.57%)of recrudescence occurred in research group,7 cases(10.00%)in the control group,the difference was not statistically significant(χ^2 =0.085,P >0.05).Conclusion Prednisone combined with indomethacin has similar effects as prednisone in the treatment of patients with subacute thyroiditis,but the combination has faster improvement of improving fever,pain,swelling,etc,and with better safety.