泼尼松与美洛昔康治疗无痛性亚急性甲状腺炎患者的效果比较  

Comparison of the clinical effects of prednisone and meloxicam in patients with painless subacute thyroiditis

作　　者：孟凡东 姜道利 沈冯洁 李萌曦 凌宏威 MENG Fandong;JIANG Daoli;SHEN Fengjie(Department of Endocrinology,the Affiliated Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou 221002,China)

机构地区：[1]徐州医科大学附属医院,江苏省徐州市221002 [2]徐州医科大学研究生学院,江苏省徐州市221002

出　　处：《临床合理用药杂志》2021年第17期24-26,29,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：江苏省高校重点实验室开放课题(No:XZSYSKF2020016)。

摘　　要：目的比较泼尼松与美洛昔康治疗无痛性亚急性甲状腺炎患者的临床效果。方法回顾性分析2017年1月-2020年3月徐州医科大学附属医院内分泌科就诊的无痛性亚急性甲状腺炎患者120例,根据随机数字表法分为2组,泼尼松治疗组60例(剂量为15.0 mg/d),美洛昔康治疗组60例(剂量为15.0 mg/d)。比较2组患者临床症状完全消失、炎性指标和甲状腺功能完全恢复所需时间。结果泼尼松组初始症状完全消失时间为(3.22±1.64)d,明显短于美洛昔康组的(16.45±4.24)d(t=22.542,P=0.000);泼尼松组C反应蛋白(CRP)完全恢复所需时间(7.05±2.14)d,明显短于美洛昔康组的(16.39±4.21)d(t=15.319,P=0.000);泼尼松组红细胞沉降率(ESR)完全恢复所需时间(7.24±1.74)d,明显短于美洛昔康组的(14.06±2.45)d(t=17.580,P=0.000)。2组甲状腺功能完全恢复所需时间比较无显著差异(t=1.429,P=0.156)。研究期间,泼尼松组出现首次应用后胃部不适3例、美洛昔康组出现2例,予以质子泵抑制剂处理后症状好转,余患者未见不良反应。结论研究证实与美洛昔康相比,使用较小剂量的泼尼松可更加有效缓解无痛性亚急性甲状腺炎患者的症状。Objective Compare the clinical effect of prednisone and meloxicam in patients with painless subacute thyroiditis.Methods 120 patients with painless subacute thyroiditis in the Department of Endocrinology,Affiliated Hospital of Xuzhou Medical University from January 2017 to March 2020,divided into 2 groups according to the random number table method,including 60 cases in the prednisone treatment group(dose 15.0 mg/d)and 60 cases in the meloxicam treatment group(dose 15.0 mg/d).We compared the time periods required for resolution of clinical symptoms and inflammatory index and normalization of thyroid function between the two groups.Results The time to complete disappearance of the initial symptoms in the prednisone group was(3.22±1.64)d,which was significantly shorter than(16.45±4.24)d in the meloxicam group(t=22.542,P=0.000).The time required for the complete recovery of CRP in the prednisone group was(7.05±2.14)d,which was significantly shorter than(16.39±4.21)d in the meloxicam group(t=15.319,P=0.000).The time required for complete ESR recovery in the prednisone group was(7.24±1.74)d,which was significantly shorter than(14.06±2.45)d in the meloxicam group(t=17.580,P=0.000).There was no significant difference in the time required for complete recovery of thyroid function between the two groups(t=1.429,P=0.156).During the study period,there were 3 cases of gastric discomfort after the first application in the prednisone group and 2 cases in the meloxicam group.The remaining patients had no adverse reactions.Conclusion Compared with meloxicam tablets,our study demonstrates that the use of smaller doses of prednisone is more effective in relieving the symptoms of painless subacute thyroiditis.

关 键 词：亚急性甲状腺炎 无痛性 泼尼松 美洛昔康 临床效果 

分 类 号：R581.4[医药卫生—内分泌]