Meta Analysis Of The Therapeutic Effect Of Selenium Supplementation Combined With Levothyroxine On Hashimoto's Thyroiditis

Background: In recent years,the incidence of Hashimoto's thyroiditis(HT)has increased year by year,but there is no uniform standard for the treatment of HT.Levothyroxine(LT4)treatment has become a routine treatment for HT.Related studies have shown that selenium supplementation combined with LT4 treatment can improve thyroid hormone levels,reduce thyroid hormone antibody levels,and delay disease progression.However,whether it is necessary to use selenium as a supplement in the treatment plan has been clinically controversial.Objective: This study intends to further verify and evaluate the clinical efficacy of LT4 combined with selenium supplementation in the treatment of HT through a meta-analysis systemic evaluation method,and compare the clinical efficacy of the two treatment options in order to determine whether selenium supplements should be used in the clinic Patients with thyroiditis provide evidence-based evidence.Method: The medical databases retrieved in this study included: PubMed,Cochrane Libarary,Embase,Web of Science,China Knowledge Network,Wanfang Database,Weipu Database.The search time was from the establishment of the database to December 1,2019.The clinical randomized controlled trial(RTC)on the theme of selenium supplementation combined with levothyroxine(LT4)in the treatment of HT was retrieved.And extract valid data,accept the qualified documents and then conduct methodological quality evaluation.In this study,RevMan 5.3 software was used for analysis.Results: A total of 271 articles were retrieved in this study.After excluding duplicate and unqualified documents,a total of 16 studies were eligible and included in this study,including 1466 patients with Hashimoto's thyroiditis,including selenium supplementation combined with levothyroxine test 733 cases in the group and 733 cases in the levothyroxine alone control group.The results of the meta-analysis showed that the serum Thyroid peroxidase antibody(TPOAb)of patients with selenium supplementation and LT4 test group was significantly lower than that of the single-use levothyroxine control group(SMD =-4.31,95% CI 4.50,-4.11),P <0.001),the serum Thyroid globulin antibody(TGAb)test group was significantly lower than the control group(selenium supplementation 200?g / d group :: SMD =-2.77,95% CI-3.01,-2.54),P <0.001;Selenium supplementation uncertain group: SMD =-1.94,95% CI(-2.29,-1.60),P <0.001).Conclusion: Selenium supplementation combined with levothyroxine tablets has a significant effect on the treatment of Hashimoto's thyroiditis,which can reduce the levels of TPOAB and TGAB and alleviate disease progression.However,there are still many problems that need to be explained and explored,and more research is needed to verify it,so as to be able to be applied to the clinic,serve the clinic,improve the quality of life of the majority of patients with Hashimoto's thyroiditis,and provide a basis for clinical medication.