内科

目的观察基于多模式持续性健康管理的强化饮食干预在131I治疗甲状腺功能亢进症合并糖尿病患者中的应用效果。方法选取113例131I治疗甲状腺功能亢进症合并糖尿病患者作为研究对象，将其随机分为对照组（56例）和观察组（57例）。对照组采用多模式持续性健康管理，观察组在对照组的基础上联合强化饮食干预，两组均干预2个月。比较两组患者血糖水平、甲状腺功能指标水平、能量消耗情况和并发症发生情况。结果干预前，两组患者的空腹血糖、餐后2h血糖水平差异均无统计学意义（均P＞0.05）。干预2个月后，观察组的空腹血糖、餐后2h血糖水平均低于对照组（均P＜0.05）。干预前，两组患者血清游离四碘甲状腺原氨酸（FT4）、游离三碘甲状腺原氨酸（FT3）、促甲状腺激素（TSH）水平差异均无统计学意义（均P＞0.05）。干预2个月后，观察组的血清FT4、FT3、TSH水平均低于对照组（均P＜0.05）。干预前，两组患者静息代谢率、静息代谢率/体质量比值差异均无统计学意义（均P＞0.05）。干预2个月后，观察组的静息代谢率、静息代谢率/体质量比值低于对照组（均P＜0.05）。干预期间，观察组患者低血糖昏迷的发生率低于对照组（P＜0.05）。结论基于多模式持续性健康管理的强化饮食干预在131I治疗甲状腺功能亢进症合并糖尿病患者的治疗中效果确切，能有效地控制血糖水平，改善甲状腺功能和能量消耗情况，减少低血糖昏迷的发生。

ObjectiveTo observe the application effect of intensive dietary intervention based on multi-mode continuous health management on patients with hyperthyroidism and diabetes treated by 131I. MethodsA total of 113 patients with hyperthyroidism and diabetes treated with 131I were selected as research objects, and they were randomly divided into the control group (56 cases) or the observation group (57 cases). The control group was intervened with multi-mode continuous health management, based on which the observation group received an intensive dietary intervention. Both groups received the intervention for 2 months. The blood glucose level, thyroid function index level, energy consumption, and occurrence of complications between the two groups were compared. ResultsBefore the intervention, there was no statistically significant difference in fasting blood glucose or 2h postprandial blood glucose level between the two groups (all P＞0.05). After 2 months of intervention, the fasting blood glucose and 2h postprandial blood glucose levels in the observation group were lower than those in the control group (all P＜0.05). Before the intervention, there was no statistically significant difference in serum level of free tetraiodothyronine (FT4), free triiodothyronine (FT3), or thyroid stimulating hormone (TSH) between the two groups (all P＞0.05). After 2 months of intervention, the serum levels of FT4, FT3, and TSH in the observation group were lower than those in the control group (all P＜0.05). Before the intervention, there was no statistically significant difference in the resting metabolic rate or resting metabolic rate/body mass ratio between the two groups (all P＞0.05). After 2 months of intervention, the resting metabolic rate and resting metabolic rate/body mass ratio in the observation group were lower than those in the control group (all P＜0.05). During the intervention, the incidence of hypoglycemic coma in the observation group was lower than that in the control group (P＜0.05). ConclusionThe intensive dietary intervention based on multi-mode continuous health management is effective in patients with hyperthyroidism and diabetes treated by 131I. It can effectively control the blood glucose level, improve thyroid function and energy consumption, and reduce the occurrence of hypoglycemic coma.