亚急性甲状腺炎合并2型糖尿病患者的中西医结合治疗

Intergrated traditional Chinese and western medicine in the treatment of subacute thyroiditis combined with type 2 diabetes mellitus

目的分析亚急性甲状腺炎合并2型糖尿病患者激素治疗及对症治疗效果。方法分析30例亚急性甲状腺炎合并2型糖尿病住院患者的临床资料及临床特点,并采用降糖干预下激素治疗及对症治疗,观察治疗效果。结果促甲状腺激素(TSH)与亚急性甲状腺炎病程有显著相关性(P<0.05)。所有患者经相应治疗,病情均得到控制,血糖控制平稳,未出现明显副作用,只出现1例亚临床甲状腺功能减退患者。经过积极降糖治疗,未发现疾病缓解与糖化血红蛋白的相关性。治疗6 d后,反映疾病缓解情况的红细胞沉降率下降值与中草药使用显著相关(P<0.05),治疗9 d后与抗生素使用显著相关(P<0.05)。结论TSH水平与亚急性甲状腺炎有显著相关性,因此其可作为亚急性甲状腺炎合并2型糖尿病住院患者预测病程的指标。对于此类患者需进行早期干预治疗,并积极控制血糖,预后不受糖化血红蛋白控制情况的影响。同时,联合中草药、抗生素治疗对疾病缓解有一定效果。

Objective To analyze the therapeutic effect of hormone and targeted treatment for patients with subacute thyroiditis combined with type 2 diabetes mellitus.Methods Clinical data and features of 30 inpatients with subacute thyroiditis complicated with type 2 diabetes mellitus were retrospectively analyzed.The hormone and symptomatic treatment were adopted under hypoglycemic intervention,and their effects were observed.Results Thyroid-stimulating hormone(TSH)was correlated with the course of subacute thyroiditis(P<0.05).By corresponding treatment,all patients significantly were in stable condition,their blood glucose was controled within normal value and no obvious side effects were observed.Only one patient had subclinical hypothyroidism.No correlation was found between disease remission and glycosylated hemoglobin.The decrease in erythrocyte sedimentation rate at 6 days after treatment was significantly associated with the use of Chinese herbal medicine(P<0.05),and with the use of antibiotics at 9 days after treatment(P<0.05).Conclusion The value of TSH is correlated with the course of subacute thyroiditis,and it can be considered as a index to predict the course of disease for inpatients with subacute thyroiditis complicated with type 2 diabetes.For such patients,early intervention and active control of blood glucose are required,and their prognosis is not affected by control condition of glycosylated hemoglobin.Combination of Chinese herbal medicine and antibiotics has a certain effect on disease remission.