2024 年第 6 期 第 0 卷

夏枯草汤加减联合二甲双胍治疗2型糖尿病合并甲状腺结节的效果及安全性分析

Analysis of effect and safety of modified Xiakucao decoction combined with metformin in the treatment of type 2 diabetes mellitus with thyroid nodules

作者：杨晓月1宋红红2胡少珍1潘颖1鲍晓雪3闫文英4

英文作者：Yang Xiaoyue1 Song Honghong2 Hu Shaozhen1 Pan Ying1 Bao Xiaoxue3 Yan Wenying4

单位：1河北医科大学第三医院药剂科，石家庄050000；2河北省任丘友谊医院内科，任丘062550；3河北医科大学第三医院内分泌科，石家庄050000；4河北医科大学第三医院临床药学部，石家庄050000

英文单位：1Departmentof Pharmacy Hebei Medical University Third Hospital Shijiazhuang 050000 China; 2Department of Internal Medicine Renqiu Friendship Hospital Hebei Province Renqiu 062550 China; 3Departmentof Endocrinology Hebei Medical University Third Hospital Shijiazhuang 050000 China; 4Department of Clinical Pharmacy Hebei Medical University Third Hospital Shijiazhuang 050000 China

关键词：2型糖尿病；甲状腺结节；夏枯草汤；二甲双胍；安全性

英文关键词：Type2diabetesmellitus;Thyroidnodules;Xiakucaodecoction;Metformin;Safety

• 摘要：

• 目的 探究夏枯草汤加减联合二甲双胍治疗2型糖尿病（T2DM）合并甲状腺结节的效果及安全性。方法 选取河北医科大学第三医院2021年3月至2022年6月接收的122例T2DM合并甲状腺结节患者为研究对象。根据随机数字表法分为联合组（61例）和西药组（61例）。西药组在常规干预的基础上给予二甲双胍，联合组在西药组的基础上加用夏枯草汤加减，2组均连续治疗3个月。比较2组甲状腺方面的临床疗效及患者治疗前后甲状腺结节数量和体积、血糖水平、甲状腺功能指标变化，同时比较不良反应发生情况。结果 经过治疗后，联合组甲状腺疗效方面的总有效率明显高于西药组［95.1%（58/61）比83.6%（51/61）］，差异有统计学意义（P=0.040）。治疗后联合组甲状腺结节数量、体积、空腹血糖、餐后2 h血糖水平少于/小于/低于西药组，差异均有统计学意义（均P<0.001）。治疗前后2组促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素水平比较差异均无统计学意义（均P>0.05）。2组患者均无严重不良反应发生，联合组与西药组轻微不良反应发生率差异无统计学意义［1.6%（1/61）比6.6%（4/61）］（χ2=0.834，P=0.361）。结论 对T2DM合并甲状腺结节患者采用中西药联合治疗，临床效果显著，应用价值较高。

• Objective To investigate the effect and safety of modified Xiakucao decoction combined with metformin in the treatment of type 2 diabetes mellitus (T2DM) with thyroid nodules. Methods Totally 122 patients with T2DM complicated with thyroid nodules admitted to the Hebei Medical University Third Hospital from March 2021 to June 2022 were selected as the research objects. According to the random number table method, they were divided into combination group (61 cases) and western medication group (61 cases). The western medication group was given metformin on the basis of routine intervention, and the combination group was given modified Xiakucao decoction on the basis of the western medication group. Both groups were continuous treated for 3 months. The clinical efficacy of thyroid, the number and volume of thyroid nodules, blood glucose level, and thyroid function indexes before and after treatment were compared between the two groups, and the incidence of adverse reactions was compared. Results After treatment, the total effective rate of thyroid efficacy in the combination group was significantly higher than that in the western medicine group［95.1%(58/61) vs 83.6%(51/61)］(P=0.040). After treatment, the number and volume of thyroid nodules, fasting blood glucose and 2 h postprandial blood glucose of the combination group were less/smaller/lower than those of the western medication group(all P<0.001). There was no significant difference in the levels of thyroid stimulating hormone, free triiodothyronine and free thyroxine between the two groups before and after treatment(all P>0.05). No serious adverse reactions occurred in the two groups, and there was no significant difference in the incidence of mild adverse reactions between the combination group and the western medication group［1.6%(1/61) vs 6.6%(4/61)］（χ2=0.834, P=0.361). Conclusion The combination of traditional Chinese and western medicine for patients with T2DM complicated with thyroid nodules has significant clinical effect and high application value.