硒酵母联合左甲状腺素钠对2型糖尿病合并慢性淋巴细胞性甲状腺炎疗效的影响

Influence of selenium yeast combined with levothyroxine sodium on outcomes in type 2 diabetes mellitus patients complicated with chronic lymphocytic thyroiditis

目的探讨硒酵母与左甲状腺素钠联合疗法对2型糖尿病合并慢性淋巴细胞性甲状腺炎(CLT)的临床疗效。方法选择温岭市中医院2017年6月至2018年12月治疗的2型糖尿病合并CLT患者96例为研究对象,采用随机数字表法分为研究组和对照组,每组48例。在血糖控制平稳的基础上,对照组患者接受左甲状腺素钠片常规治疗,研究组患者在此基础上加服硒酵母。观察记录两组患者治疗3个月内血糖、甲状腺素水平的变化及临床疗效。结果研究组总治疗有效率为95.83%(46/48),显著高于对照组的68.75%(33/48)(χ^2=12.080,P<0.05);研究组治疗后空腹及餐后2 h血糖、糖化血红蛋白水平均显著低于对照组(均P<0.05),空腹及餐后2 h C肽水平显著高于对照组(t=4.927~8.725,均P<0.05)。研究组治疗后血清硒水平显著高于对照组(P<0.05),而血清甲状腺过氧化物酶抗体及甲状腺球蛋白抗体水平均显著低于对照组(t=17.264~27.032,均P<0.05),且两组患者治疗后血清促甲状腺激素、游离三碘甲状腺原氨酸和游离甲状腺素水平差异均无统计学意义(t=0.704~1.926,均P>0.05)。结论硒酵母联合左甲状腺素钠治疗2型糖尿病合并CLT,可有效提高临床治疗效果。

Objective To investigate the clinical efficacy of combination therapy of selenium yeast and levothyroxine sodium in the treatment of type 2 diabetes mellitus complicated with chronic lymphocytic thyroiditis(CLT).Methods A total of 96 patients with type 2 diabetes mellitus complicated with CLT who admitted to Wenling Hospital of Traditional Chinese Medicine from June 2017 to December 2018 were randomly divided into control group and treatment group according to the digital table,with 48 patients in each group.On the basis of stable blood sugar control,the control group received routine treatment with levothyroxine sodium tablets.The treatment group was given selenium yeast on the basis of the control group.The blood glucose,thyroid,clinical efficacy within 3 months of treatment were recorded.Results The total effective rate of the study group was 95.83%(46/48),which was significantly higher than 68.75%(33/48)of the control group(χ^2=12.080,P<0.05).The levels of blood sugar and glycosylated hemoglobin in the study group were significantly lower than those in the control group after treatment(all P<0.05),and the levels of C-peptide in the fasting and postprandial 2h were significantly higher than those in the control group(t=4.927-8.725,all P<0.05).After treatment,the serum selenium level in the study group was significantly higher than that in the control group(P<0.05),and the serum TPOAb and TGAb levels were significantly lower than those in the control group(t=17.264-27.032,all P<0.05).There were no statistically significant differences in serum TSH,FT3 and FT4 levels between the two groups(t=0.704-1.926,all P>0.05).Conclusion The clinical efficacy of selenium yeast and levothyroxine in the treatment of type 2 diabetes with CLT is significantly better than traditional treatment.