甲巯咪唑联合普萘洛尔治疗甲状腺功能亢进症的疗效观察

方勇明?吕铭?曾晓春?梁红英?刘玉芬

[摘要] 目的 观察评价甲巯咪唑（methimazole）联合普萘洛尔（propranolol）治疗甲状腺功能亢进症（hyperthyroidism）的临床效果。方法 选择2014年3月～2017年1月期间我院收治的甲亢患者58例，随机对照试验（RCT）分为两组，对照组29例给予甲巯咪唑治疗；观察组29例在对照组基础上给予普萘洛尔治疗，并比较两组的临床效果。结果 观察组总有效率为96.55%而显著地高于对照组79.31%（χ2=4.061，P<0.05），两组治疗前FT3、FT4、TSH水平比较，差异均无统计学意义（P>0.05），治疗8周后，两组患者FT3、FT4、TSH水平均优于治疗前（P<0.05），观察组治疗后FT3、FT4水平均优于对照组（P<0.05），观察组治疗后TSH与对照组比较差异无统计学意义（P>0.05）。结论 甲巯咪唑联合普萘洛尔治疗甲状腺功能亢进症，能够显著地改善临床症状，治疗效果确切显著，值得临床推广应用。

[关键词]甲巯咪唑；普萘洛尔；甲状腺功能亢进症

[中图分类号] R581.1 [文献标识码] A [文章编号] 2095-0616（2017）09-191-04

The efficacy of methimazole combined with propranolol in the treatment of hyperthyroidism

FANG Yongming LV Ming ZENG Xiaochun LIANG Hongying LIU Yufen

Department of Medicine， Liaobu Hospital， Dongguan City， Dongguan 523400， China

[Abstract] Objective To observe the clinical effect of methionimidazole（methimazole） combined with propranolol（propranolol） in the treatment of hyperthyroidism（hyperthyroidism）. Methods 58 patients with hyperthyroidism in hospital from March 2014 to January 2017 were randomly divided into two groups. 29 cases in control group were given methimazole treatment， and 29 cases in observation group were given methimazole combined with propranolol. The clinical effects were compared between the two groups. Results The total effective rate of the observation group was 96.55%， which was significantly higher than that of the control group in 79.31%（χ2= 4.061， P<0.05）. There was no significant difference in FT3， FT4 and TSH levels between the two groups before treatment （P>0.05）. After 8 weeks of treatment， the levels of FT3， FT4 and TSH in the patients of the two groups were better than those before treatment（P<0.05）. After treatment， the levels of FT3 and FT4 in the observation group were better than those in the control group（P<0.05）. After treatment， there was no significant difference in TSH between the observation group and the control group（P>0.05）. Conclusion Methimazole combined with propranolol in the treatment of hyperthyroidism， can significantly improve the clinical symptoms. Its treatment effect is significant， worthy of clinical application. It is worthy of clinical application.

[Key words] Methimazole； Propranolol； Hyperthyroidism

甲状腺功能亢进症（hyperthyroidism）简称甲亢，是常见内分泌疾病中的自身免疫性疾病，女性的发病率高于男性，往往为突眼、多汗、多食、眼睑水肿、体质量下降、视力减退、消瘦、心悸、四肢酸软等引起以神经、循环、消化等系统兴奋性增高和代谢亢进为主要表现的一组高代谢症状疾病[1-3]。甲亢病理表現为甲状腺弥漫性、混合性或者结节性肿大等。有效控制病情的发展是降低疾病并发症发

生率和病情逆转的关键，对甲亢患者治疗原则为迅速缓解甲状腺亢进和纠正代谢紊乱状况。主要包括药物治疗、手术治疗及放射性131碘治疗等，其中最为常用方案是药物治疗[4-7]。本研究运用甲巯咪唑联合普萘洛尔治疗甲状腺功能亢进症患者29例，取得满意的效果，现报道如下。

1 资料与方法……