Clinical Experience And Experimental Study On The Treatment Of Nodular Goiter With Fen - Rich Compound

Purpose:1.Through learning from teacher,analysis and summarize the clinical experience and the use of Professor Gao Tianshu in treating various types of nodular goiter.To investigate academic thinking, clinical experience of tutor in nodular goiter and the use of rich iodine Chinese herbal, aiming to provide a good idea for the clinical treatment of nodular goiter. 2.To determine the content of iodine in iodine rich elements of traditional Chinese medicine, and analyze the factors affecting the determination process. 3.To compare Yingning mixture and iodine excess iodine metabolism distribution and expression of NIS protein in thyroid follicular epithelial cells of the body in nodular goiter in rats, than clear Yingning mixture in the treatment of nodular goiter effect mechanism.Material and method:1.By following the tutor clinical practice, summarize the clinical findings of all kinds of cases, induction, analysis and summary. Reading a lot of literature, refining the academic thought of Prof. Gao Tianshu,consolidate and analysis the experience, ideas and academic thoughts. 2.The principle fom catalytic spectrophotometry.The configuration of a series of standard solution iodine concentration respectively 200, 400, 600, 800, 1000, 1200g/L, respectively take standard solution to added into the zinc sulfate, potassium carbonate, sodium chloride and potassium chlorate mixed alkaline ashing auxiliary agent for about 2h, the ash dissolved in deionized water, supernatant after arsenic cerium determination of iodine content of catalytic spectrophotometry.According to C(iodine content) and A(optical density) of iodine content calculation of linear relationship between,for the establishment of standard curve.Seaweed, kelp, Haidai represents rich iodine Chinese herbal medicine, for the best ashing temperature and recoveryexperiment.Than determinate iodine content in common traditional Chinese medicine at the best testing condition after the establishment of standard curve.Rich iodine Chinese herbal medicine on different decocting time weremeasured, drawing the iodine content of Decoction and decoction time curve, choose the best decocting time. 3.SPF level of 62 SD rats were selected.A week after adaptive feeding randomly selected 10 only for NG, the remaining 52 were to PTU gavage, the dose of 1mg/100 g rats, 14 days after the gavage randomly selected 2 rats of model validation. The 50 rats were randomly divided into 5 groups, respectively MG(10), Yingning No. 1 group(10 rats), Yingning No. 2 group(10), HG(10), IG(10) after model successfully reproduced.NG and MG were administered saline 3ml daily gavage, Yingning No. 1 group to Yingning No. 1 concentrated decoction 3ml, Yingning No. 2 group to Yingning No. 2, 3ml, HG to be concentrated decoction of iodine rich concentrated decoction 3ml, IG be potassium iodate solution 3ml,consecutive gavage for 28 days.On the 27 th day the rats were placed in metabolic cages, collected 24 hours urine, feces in rats. After intervention to intraperitoneal anesthesia, the rats were killed, taken in rat arterial blood, thyroid tissue. Using alkaline ashing arsenic cerium determination of rat serum, urine, feces, the iodine content in thyroid tissue by spectrophotometry, using radioimmunoassay was used to detect the expression of serum T3, T4, TSH, HE staining were observed on thyroid morphology in rats, the NIS protein in rat thyroid were measured with Western Blotting method, immunohistochemistry and fluorescent immunohistochemical expression of NIS protein was determined in rat thyroid follicular epithelium.Results:1. Qi stagnation, blood stasis and phlegm coagulation were the pathologic factors of nodular goiter, Qi, promoting blood circulation and eliminating phlegm were the method of this disease.The dialectical method is required to debate the actual situation with normal thyroid function, antibody normal nodular goiter patients.My teacher thinks that nodular goiter belongs to the early empirical,the medium-term belongs to the actual inclusion, late for deficiency syndrome.Tutor is good at applying Yingning mixture 1 of dialectical theory of governance.The instructor suggested rich iodine Chinese herbal medicine should be used with caution or short against the use of nodular goiter with hyperthyroidism and subclinical hyperthyroidism, long time use will be to restore the effect of thyroid function. The tutor onthe disease resolution gas, differentiation of blood, sputum, use Yingning mixture 2 of dialectical theory of governance.The instructor suggested not use rich iodine Chinese herbal medicine treatment of nodular goiter withhypothyroidism or subclinical hypothyroidism patients, avoid high dose iodine produced inhibitory effect on thyroid function.The clinical stage of dialectical theory of governance, and puts forward the disease occurs in women, clinical use Yingning mixture 2 and Buzhongyiqi Decoction application.Phlegm, blood stasis as high-risk nodules or after operation of thyroid nodules in the main factors, Yingning mixture 2 addition and subtraction 2. This experiment improved the detection method of iodine content of Chinese herbal medicine, The recovery experiment proved that the experimental method is accurate, reproducible high. This experiment proved the best time rich iodine Chinese herbal medicine decocting process, the optimal ashing temperature, further defined the iodine rich and common herbal iodine content and the elimination of iodine content of Yingning mixture decoction. 3. After the PTU by gavage for 14 days,the normal group of thyroid by naked eye observation were mostly pale pink, soft texture.The thyroid of MG was dark red, swollen thyroid tissue apparent hyperaemia, and have certain toughness. thyroid follicular significantly unequal in size under light microscope compared with NG,Follicular cavity becomes small, irregular in shape, cavity glial significantly reduced, single layer hyperplasia cubicepithelial cell hypertrophy multicoat, parts of the follicle is formed by the fusion of giant follicle, follicular cavity and interstitial showed a large amount of inflammatory cell infiltration,visible small part of follicular hyperplasia, form a closed cavity free cell group, perifollicular blood vessel rich, prompting goiter model successfully reproduced.All rats body weight change trend is consistent.MG, Y1 G, Y2 G, HG and IG in rats with lower body weight, Compared with NG for second weeks,P<0.05; Y1 G, Yingning mixture 2 fifth week and sixth week body weight was higher compared with IG,P<0.05, Y1 G and Y2 G there was no significant difference,P>0.05; The comparison of the relative weight of thyroid, Y2 G, HG and IG the higher the relative weight of thyroid compared with NG, MG, P<0.05; Y1 G, Y2 G, HG and IG, the lower the relative weight of thyroid compared with MG, P<0.05; Y1 and G had no statistical difference of thyroid weightcompared with NG,P > 0.05. Comparison of serum iodine content, Y1 G, Y2 G, HG and IG iodine content increased obviously compared with NG, P<0.05; Y1 G, Y2 G, HG in serum of iodine content was lower compared with IG, P<0.05; HG Y1 G, a high iodine content compared with the Y2 G, P<0.05.The urine iodine content in comparison, Y1 G, Y2 G, HG and IG significantly increased thecontent of iodine compared with NG,P<0.05; Y1 Gand HG was higher,Y2 G is low compared with IG,P<0.05; Y1 G urine iodine content was high compared with HG, P<0.05.Comparison of fecal iodine content Y1 G, HG and IG were high iodine content compared with NG, P<0.05; Y1 G, HG and IG were high compared with the Y2 G, P<0.05.Comparison of thyroid iodine content, compared with NG, Y1 G, Y2 and high iodine content of G, HG and IG in the thyroid, lower contents of MG, P<0.05; compared with IG, Y1 G, Y2 G, the higher HG in thyroid iodine content, P<0.05; compared with the Y2 G, higher X and 1G HG in the thyroid iodine content, P<0.05; compared with HG, the higher Y1 G in thyroid iodine content, P<0.05.Thyroid morphological comparison: NG: the thyroid follicular epithelial cells are of medium size, a cubic or flat,follicular cavity filled with rich microglia; MG: the disappearance of follicular cavity near 90%, follicular epithelial cells significantly increased deformation, 80% follicular lichen, visible small part of follicular hyperplasia, follicularangiogenesis around the cell mass closed without the abundance of Y1 G cavity;: gland follicular recovery of medium size, epithelial cells are cuboidal or flattened, follicular cavity filled with rich microglia, occasionally inflammatory cell mass in see, returned to normal; Y2 G: thyroid follicular epithelial cells and better recovery, form a more rules, can still be seen in follicular cavity and interstitial infiltrates of inflammatory cells; HG: the thyroid follicular epithelial cells and better recovery, but still visible follicular cavity and interstitial infiltrates of inflammatory cells; IG: recover part of the thyroid follicular epithelial cells, but there are still some follicles fused to form giant follicular, still visible follicular cavity and interstitial infiltrates. Inflammatory cells. Comparison of thyroid function in rats: comparison of TT3, higher HG, IG content of TT3 compared with NG, P<0.05; TT4 comparison, higher HG, IG content of TT3 compared with NG, P<0.05; compared with IG, HG, Y1 G and HG TT4 content is low, P<0.05. MG, Y2 G were high than NG, P<0.05.Comparison of Western blotting, Y1 G and HG OD value is higher, compared with IG. The expression ofNIS protein in thyroid immunohistochemical expression results in the area:Compared with NG, Y1 G, Y2 G, HG and IG with larger area, MG area is small, P<0.05. Compared with IG, Y1, Gand HG expression in Y2 area is larger, the expression of G in small area, P<0.05. Compared with HG, Y1 G expression in the area is larger, P < 0.05 according to each fluorescence expression, in order from strong to weakexpression of NIS fluorescence: Y1 G > HG > IG > Y2 G > NG > MG.Conclusion:1.Iodine rich herbal should be combined with the thyroid function in patients, antibody level in treatment of nodular goiter. 2.This experiment improved the detection method of iodine content of Chinese herbal medicine, the recoveryexperiment, the experimental method is accurate, reproducible high. To prove the best time rich iodine Chinese herbal medicine decocting process, the optimal ashing temperature, further defined the iodine rich and common herbal iodine content and the elimination of iodine content of gall mixture decoction. 3.Yingning Decoction can increase the iodine content of the thyroid in iodine deficiency, but not caused by hyperthyroidism. Morphological comparison, Yingning mixture curative effect is better than iodine excess.