Objective To observe the clinical effect of selenium yeast combined with levothyroxine sodium on type 2 diabetes complicated with chronic lymphocytic thyroiditis (CLT).Methods Totally 78 type 2 diabetic patients with CLT from June 2015 to November 2016 in the 452 Hospital of the Chinese People's Liberation Army were randomly divided into group A and group B,with 39 cases in each group.Group A took levothyroxine sodium tablets based on basic hypoglycemic therapies;group B took selenious yeast tablets in addition.Blood glucose,thyroid function indexes,clinical efficacy and adverse reactions were analyzed.Results Levels of fasting blood glucose,postprandial 2 h blood glucose,glycosylated hemoglobin,thyroid peroxidase antibody and thyroglobulin antibody after treatment in group B were significantly lower than those in group A [(5.00 ± 0.10) mmol/L vs (5.60±0.30)mmol/L,(8.50 ±0.40)mmol/L vs (10.60 ± 0.40) mmol/L,(4.70 ±0.20)％ vs (5.80±0.13) ％,(119 ± 19) mU/L vs (290 ± 31) mU/L,(87 ± 19) mU/L vs (172 ± 22) mU/L];levels of fasting C peptide and postprandial 2 h C peptide after treatment in group B were significantly higher than those in group A [(2.06 ± 0.21) μg/L vs (1.27 ± 0.22) μg/L,(5.27 ± 0.43) μg/L vs (2.63 ± 0.26) μg/L] (all P ＜ 0.05).The total effective rate in group B was significantly higher than that in group A[94.9％ (37/39) vs 69.2％ (27/39)] (P ＜ 0.05).After treatment,improvement rate of clinical symptoms (thyroid pain,swelling and myxedema) in group B was significantly higher than that in group A(P ＜ 0.05).The incidence rate of adverse reactions in group B was significantly lower than that in group A[0.0％(0/39) vs 10.3％(4/39)](P＜0.05).Conclusion Selenium yeast combined with levothyroxine sodium treating type 2 diabetes with CLT is effective in relieving symptoms,reducing adverse reactions and improving life quality.%目的 观察硒酵母联合左甲状腺素钠治疗2型糖尿病合并慢性淋巴细胞性甲状腺炎(CLT)的临床效果.方法 选取2015年6月至2016年11月解放军第四五二医院收治的明确诊断为2型糖尿病合并CLT的患者78例,完全随机分为A、B组,各39例.2组均给予常规基础降糖治疗,另A组口服左甲状腺素钠片常规治疗,B组在A组基础上加服硒酵母片治疗,2组均进行3个月治疗.观察2组患者治疗前后血糖、甲状腺功能相关指标、临床疗效、临床症状改善情况及不良反应发生情况.结果 治疗后,B组空腹及餐后2h血糖、糖化血红蛋白、甲状腺过氧化物酶抗体、甲状腺球蛋白抗体水平明显低于A组[(5.00 ±0.10) mmol/L比(5.60±0.30) mmol/L、(8.50±0.40) mmol/L比(10.60±0.40) mmol/L、(4.70±0.20)％比(5.80±0.13)％、(119±19)mU/L比(290±31) mU/L、(87±19) mU/L比(172±22)mU/L],空腹及餐后2h血清C肽水平明显高于A组[(2.06 ±0.21) μg/L比(1.27±0.22) μg/L、(5.27±0.43) μg/L比(2.63±0.26)μg/L],差异均有统计学意义(均P＜0.05).B组总有效率明显高于A组[94.9％ (37/39)比69.2％ (27/39)],差异有统计学意义(P＜0.05).治疗后B组患者临床症状(甲状腺疼痛、甲状腺肿胀、黏液性水肿)改善率明显高于A组,差异有统计学意义(P＜0.05).B组不良反应发生率低于A组[0.0％(0/39)比10.3％ (4/39)],差异有统计学意义(P＜0.05).结论 硒酵母联合左甲状腺素钠方案治疗2型糖尿病合并CLT临床效果明显,而且较为安全,患者的生存质量得到明显改善.
展开▼
