左旋甲狀腺素片和甲狀腺片治療甲狀腺結節的效果及安全性對比

鄧韻+劉苑清

【摘要】 目的：探討并對比左旋甲狀腺素片和甲狀腺片治療甲狀腺結節的效果及安全性。方法：選取2015年9月-2016年11月在本院接受治療的甲狀腺結節患者92例，按照治療方式的不同將其分為觀察組和對照組，每組各46例。對照組采用甲狀腺片治療，觀察組采用左旋甲狀腺素片治療，兩組治療時間均為6個月，觀察記錄兩組患者的各項臨床指標，包括治療效果、游離三碘甲狀腺原氨酸（FT3）水平、游離甲狀腺素（FT4）水平、促甲狀腺激素（TSH）水平和不良反應的發生情況等。結果：觀察組治療總有效率明顯高于對照組，比較差異有統計學意義（P<0.05）；兩組患者治療后結節直徑均小于治療前，且觀察組患者治療后結節直徑小于對照組（P<0.05）；治療后，觀察組FT3和FT4水平均高于對照組，且兩組FT3和FT4水平均高于治療前，比較差異均有統計學意義（P<0.05）；治療后，觀察組TSH水平低于對照組，且兩組TSH水平均低于治療前，比較差異均有統計學意義（P<0.05）；觀察組不良反應發生率明顯低于對照組，比較差異有統計學意義（P<0.05）。結論：與甲狀腺片相比，應用左旋甲狀腺素片治療甲狀腺結節能夠取得更好的療效，患者結節減小的更顯著，激素水平也得到更有效調整，且不良反應發生更少，安全性更高，值得在臨床推廣應用。

【關鍵詞】 左旋甲狀腺素片； 甲狀腺片； 甲狀腺結節； 治療效果； 安全性

【Abstract】 Objective：To investigate and compare the efficacy and safety of L-thyroxine and Thyroid Tablets in treatment of thyroid nodules.Method：92 cases of thyroid nodules were treated in our hospital from September 2015 to November 2016 were selected，according to the different treatment methods，they were divided into observation group and control group，46 cases in each group.The control group was Treated with Thyroid tablets，and observation group was treated with L-thyroxine，they were treated for 6 months.The clinical parameters of the two groups were observed and recorded，including the therapeutic effect，free triiodothyronine（FT3） levels，free thyroxine（FT4） levels，thyroid stimulating hormone（TSH） levels and the incidence of adverse reactions.Result：The total effective rate of observation group was significantly higher than that of control group，the difference was statistically significant（P<0.05）.The diameter of nodules in two groups after treatment were smaller than those before treatment，and the diameter of nodules in observation group after treatment was smaller than that of control group（P<0.05）.After treatment，the levels of FT3 and FT4 in observation group were higher than those of control group，and the levels of FT3 and FT4 in two groups were higher than those of before treatment，the differences were statistically significant（P<0.05）.After treatment，the level of TSH in observation group was lower than that of control group，and the level of TSH in two groups were lower than those of before treatment，the differences were statistically significant（P<0.05）.The incidence of adverse reactions in observation group was significantly lower than that of control group，the difference was statistically significant（P<0.05）.Conclusion：Compared with Thyroid Tablets，the application effect of L-thyroxine treatment of thyroid nodules can get better，more significant decrease of patients with nodular，hormone levels have been more effective adjustment，and less adverse reaction，high safety，it is worthy of clinical applicationendprint

【Key words】 L-thyroxine； Thyroid Tablets； Thyroid nodules； Treatment effect； Safety

First-authors address：The First Peoples Hospital of Shaoguan， Shaoguan 512000，China

doi：10.3969/j.issn.1674-4985.2017.31.015

甲狀腺是人體最為重要的內分泌腺之一，甲狀腺結節是臨床上常見的內分泌系統疾病，是甲狀腺細胞異常生長的病變，表現為甲狀腺局部出現一個或多個組織結構異常的團塊[1]，結節可隨吞咽動作上下移動，病變初期甲狀腺可能出現局部增生，患者不會有明顯的不適。甲狀腺結節無明顯臨床癥狀，一般在體檢中檢查出來[2]。目前對于該病的具體致病因不明，臨床上認為碘的攝入量不足、患者飲食習慣、病毒感染、藥物使用情況、吸煙以及放射線暴露情況都可能成為影響因素，中醫認為甲狀腺結節的主要是飲食不節、氣機不暢、停痰留瘀所致[3]。近年來甲狀腺結節的發病率呈現上升趨勢，其常表現為單發或多發，雖然甲狀腺結節絕大多數為良性，但是其具有增長迅速和質地較硬的特點，對于外觀會有一定程度的影響，嚴重時會并發甲狀腺功能異常[4]，因此患者應該對其進行及時的治療。……