The Clinical Exploration Study Of Shugan Jianpi Decoction In Treatment Of Hashimoto Thyroiditis

Objective:Hashimoto’s thyroiditis is a common autoimmune thyroid disease,its morbidity is increasing.Women are the main group of hashimoto’s thyroiditis,which is the most common cause of primary hypothyroidism.Generally,the onset of the disease is hidden without obvious discomfort in the early stage,and the rate of missed diagnosis is high in the normal population.It has found that hashimoto’s thyroiditis may be related to many kinds of disease,however,there is no effective treatment for the disease.Therefore,in-depth studies are needed to find out the exact and effective treatment of hashimoto’s thyroiditis.This is a clinical exploration study of comparing traditional Chinese medicine(Shugan Jianpi Decoction)united selenium yeast tablets with selenium yeast tablets in the treatment of Hashimoto thyroiditis with normal thyroid function.It aims to observe the improvement of thyroid globulin antibody(TgAb),thyroid peroxidase antibody(TPOAb)titer and clinical symptoms in the treatment group and the control group before and after treatment for 8 weeks and preliminarily discuss the effect and safety of Shugan Jianpi Decoction in the treatment of hashimoto thyroiditis.In addition,the etiology and pathogenesis of hashimoto’s thyroiditis were discussed,and the mechanism of treating hashimoto’s thyroiditis from the perspective of liver and spleen was analyzed.Method:Randomly divided aging from 18 to 70 years of 46 outpatients who met the diagnostic standard of hashimoto thyroiditis with normal thyroid function and Liver-Qi Stagnation and Spleen Deficiency syndrome into observation group(with the number of 24)and control group(with the number of 22)through a randomized,parallel control study.Based on a low-iodine diet,a regular and healthy lifestyle,observation group was treated with traditional Chinese medicine Shugan Jianpi Decoction(Drug composition:bupleurum,fragrant,angelica sinensis,radix paeoniae paeoniae paeoniae,poria cocos,sauteed albino,broiled liquorice),one dose per day,divided into two times,combined with selenium yeast tablets 150ug,2 times per day and control group was treated with single selenium yeast tablets 150ug,2 times per day.Four weeks is a course of treatment,take two courses continuously,take medicine immediately after diagnosis,observe eight weeks continuously.Before the test,record the patients’ general indicators,including gender,age,and body temperature,respiration,resting heart rate,more than 10 minutes rest blood pressure,and thyroid function,thyroid ultrasound.The titers of serum thyroid peroxidase antibody(TPOAb)and thyroid globulin antibody(TgAb)in patients with hashimoto’s thyroiditis were detected by electrochemiluminescence before and after the test.At the same time,TCM syndrome score was recorded according to TCM syndrome score standard,and the changes of thyroid antibody titer and the improvement of clinical symptoms of the two groups of patients before and after treatment were analyzed.Moreover,adverse drug reactions and toxic side effects were observed.In addition,blood routine test,urine routine test,excrement routine test,liver and kidney function,and electrocardiogram were tested before and after the trial to evaluate its safety.The data of trial was analyzed by the use of SPSS24.0.The measurement data were expressed by the standard deviation of mean person and compared by t test while counting data shall be checked by chi-square test.Results:All the cases observed in this study come from the department of endocrinology,Xiyuan Hospital,China Academy of Traditional Chinese medicine.A total of 46 cases were included.At the end of the trial,in the treatment group 5 patients were lost(One patient lost contact,four patients did not take medicine as required and adhere to 1/2 course of treatment)while 4 cases were lost in the control group(One patient did not take the medicine as required and adhere to 1/2 course of treatment,three patients refused to continue to participate in this study).One patient in the treatment group and three in the control group occur hypothyroidism.1.The treatment group was significantly improved in TCM syndromes(such as anterior cervical and pressure,pharyngeal foreign body sensation,abdominal pain,emotional depression or irritability)(P<0.05).The control group was improved only in epigastric pain before and after treatment(P<0.05).2.Compared with the control group,the treatment group was significantly better than the control group in improving anterior cervical and pressure,pharyngeal foreign body sensation(P<0.05).3.Comparison of total TCM syndromes between before and after treatment in the treatment group showed statistically significant difference(P<0.05),while the control group showed no statistically significant difference.4.Compared with the control group,the treatment group was significantly improved in total score of TCM syndromes,with P<0.05.5.There is no significant difference in the level of the serum titers of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb)both inter-group comparison and intra-group comparisons(P>0.05).6.There was no statistical difference in the probability of hypothyroidism between the treatment group and the control group during the trial.Conclusion:1.Shugan Jianpi Decoction significantly improved TCM syndromes in HT patients with Liver-Qi Stagnation and Spleen Deficiency syndrome.2.There was no significant improvement in TPOAb and TgAb titer in patients with hashimoto’s thyroiditis,which may be related to short observation period and small sample size,and Shugan Jianpi Decoction’s effectiveness needs further study.3.No significant side effects of Shugan Jianpi Decoction and Selenium yeast tablets were found in the experiment and the safety was good.