分层评价指导治疗对改善亚急性甲状腺炎复发率和甲减发生率的临床研究

Stratified evaluation of guided treatment for improvement of subacute thyroiditis clinical study on recurrence rate and incidence of hypothyroidism

目的 探究分层评价指导治疗对亚急性甲状腺炎(SAT)患者甲减发生率和复发率、不良反应发生情况的影响。方法 随机选取2020年6月—2023年6月该院门诊及病房收治的168例SAT患者,按照SPSS随机数字表,采用1:1:1随机分组,其中局部注射组(n=56)和口服治疗组(n=56)为对照组,分层评价组(n=56)为治疗组。通过基于临床实践经验自主设计的甲状腺损害程度和复发风险评分表进行分层评价。分析三组患者的一般资料、甲减发生率、复发率、临床疗效(疼痛缓解时间、发热缓解时间、1个月后血沉及甲功恢复情况)及不良反应发生情况。结果 三组患者性别、年龄、发病至就诊时间、症状特点、炎症指标、甲功情况间比较,差异无统计学意义(P>0.05)。与局部注射组、口服治疗组比较,分层评价组甲减发生率和复发率均降低(P<0.05);与口服治疗组比较,分层评价组和局部注射组疼痛、发热症状缓解时间缩短(P<0.05);与口服治疗组比较,局部注射组、分层评价组1个月后血沉、甲功恢复正常率情况差异有统计学意义(P<0.05),分层评价组比局部注射组1个月后甲功恢复正常率高,差异有统计学意义(P<0.05);与口服治疗组比较,分层评价组和局部注射组空腹血糖、果糖胺、体重变化等差异有统计学意义(P<0.05)。结论 通过分层评价方式选择合适的SAT针对性治疗方案,可令甲减发生率降低,复发率降低,症状缓解快,血沉、甲功恢复效果较好。

Objective To explore the effects of stratified evaluation of guided treatment on the incidence and recurrence of hypothyroidism and adverse reactions in patients with subacute thyroiditis(SAT).Methods A total of one hundred and sixty-eight SAT patients admitted to the outpatient department and wards of the hospital from June 2020 to June 2023 were randomly selected and divided into groups according to the SPSS random number table at 1:1:1.Among them,local injection group(n=56)and oral treatment group(n=56)without stratified evaluation were control groups,and stratified evaluation group(n=56)was treatment group.Stratified evaluation of thyroid damage degree and recurrence risk was carried out by self-designed thyroid injury scale based on clinical practice experience.The general information,incidence of hypothyroidism,recurrence rate,clinical efficacy(pain relief time,fever relief time,sedimentation rate and recovery of thyroidism after 1 month)and adverse reactions of the three groups were analyzed.Results Analyze the general information,incidence of hypothyroidism,recurrence rate,clinical efficacy(pain relief time,fever relief time,erythrocyte sedimentation rate and nail function recovery after 1 month),and incidence of adverse reactions of three groups of patients.There was no statistically significant difference(P>0.05)among the three groups of patients in terms of gender,age,time from onset to visit,symptom characteristics,inflammatory indicators,and nail function.Compared with local injection group and oral treatment group,the incidence and recurrence rates of hypothyroidism in stratified evaluation group were reduced(P<0.05).Compared with oral treatment group,stratified evaluation group and local injection group had a shorter relief time for pain and fever symptoms(P<0.05).Compared with oral treatment group,local injection group and stratified evaluation group had a higher rate of normal recovery of erythrocyte sedimentation rate and nail function after one month(P<0.05).Compared with oral treatment group,stratified evaluation group and local injection group showed statistically significant differences in fasting fructose,block glucose,and weight change(P<0.05).Conclusion Choosing a suitable SAT targeted treatment plan through a stratified evaluation method can reduce the incidence and recurrence rate of hypothyroidism,alleviate symptoms quickly,and achieve good recovery effects in erythrocyte sedimentation rate and nail function.