Cross-sectional Investigation Of Hyperthyroidism And Analysis Of The Law Of Diagnosis And Treatment Of Traditional Chinese Medicine

This paper is divided into two parts:theoretical research and clinical research.1.Theoretical research The first three chapters are theoretical studies,summarizing the knowledge of hyperthyroidism,the treatment of hyperthyroidism,and summarizing the clinical experience of the instructor in the treatment of hyperthyroidism.2.Clinical researchThrough clinical investigation,the characteristics,etiology,symptoms,diagnosis and treatment of hyperthyroidism,and the rule of drug use are summarized to provide reference for clinicians in the treatment of hyperthyroidism.And then by discussing the correlation of"disease-drug-syndromes-prescription" it is concluded that the Chinese medicine staging treatment plan for hyperthyroidism.2.1 Cross-sectional medical record surveyA total of 496 patients with hyperthyroidism are enrolled.The medical records of 496 patients are entered into the Microsoft Excel form by the two persons to establish a database.And The input data is bidirectionally corrected and copied to the IBM SPSS.25 software.Counting data are expressed as frequency(f)and percentage(%),quantitative data are expressed as mean±standard deviation.Chi-square test,nonparametric test and so on were used in statistical methods.The clinical findings are as follows:(1)Young and middle-aged people are prone to hyperthyroidism,and most of them are female.Hyperthyroidism occurs mostly in 30-40-year old women.(2)The onset is related to physique,and physical tiredness and bad mood are easy to induce hyperthyroidism:56 cases had family history,29.84%of all had unknown causes.The number of people with hyperthyroidism caused by fatigue(20.36%)or negative life events(17.94%)and night work(16.33%)is very large.(3)The incidence is on the rise,and preventing recurrence is a problem:the number of patients with disease duration<1 year is the highest(45.77%),the longest course was 28 years,and the disease duration group(>3 years)accounts for 27.42%.These data indicate that hyperthyroidism is prone to relapse on the basis of physical fatigue,depression,bad eating habits and other inducements.(4)Specialized examination is indispensable,neck vascular murmur is helpful in early diagnosis:In this study,the proportion of patients with increased pulse pressure difference was 6.26%.Most of the cases studied are accompanied by goiter of different degrees,of which the second degree goiter(52.22%)is the largest,and the first degree goiter(21.17%)is right behind,as well as the mild to moderate exophthalmos(31.45%,6.45%,respectively)are also more common.The occurrence rate of vascular murmur in the neck is higher(34.68%),which is a common sign in hyperthyroidism patients.The faster the heart rate is,the more likely it is to appear vascular murmur,and the occurrence of vascular murmur is related to the condition of the disease.The order of incidence was treatment period>reducing period>convalescence stage,the difference was statistically significant.(5)The clinical symptoms are complicated,and the adverse reactions of western medicine are many:The top 10 symptoms with the highest frequency of hyperthyroidism are cervical swelling and discomfort,panic,irritability,fear of heat,sweating,palmar fever,tremor,insomnia,swelling and pain of the eye,and swelling of the neck,and the proportionof these symptoms is more than 30%.In addition,tongue red or thin white fur is the most common clinical tongue image,the fast and chordal veinlets are the common clinical pulse.Of the 380 patients treated with antithyroid drugs,56(14.74%)had adverse drug reactions,mainly liver damage,leukopenia,pruritus and gastrointestinal reactions.(6)The pattern of TCM syndrome is mainly yin deficiency and yang hyperactivity.(7)The distribution of syndrome type is related to hormone level:The highest thyroid hormone level was found in Yin deficiency and Yang hyperactivity syndrome and Heart-liver Yin deficiency Syndrome and the level of TSH is lowest.The level of thyroid hormone is the lowest and the level of TSH is higher in the type of deficiency of both qi and yin.The levels of thyroid hormone and TSH in patients with liver stagnation and spleen deficiency and Qi stagnation and dampness obstruction are close to each other.(8)According to the prescription and certificate,the rule of application of prescription can be explored:Common prescription can be divided into five categories.(9)Treatment of complications is based on etiology and the curative effect of traditional Chinese medicine can be repeated play an important role in hyperthyroidism complicated with arrhythmias.Both drug-induced liver damage and liver damage caused by hyperthyroidism often use Bupleurum to soothe liver qi,but drug-induced liver damage is mainly accompanied by antipyretic,dampness-clearing and detoxification drugs,supplemented by tonifying spleen and tonifying the spleen.The liver damage caused by hyperthyroidism was dominated by tonifying drugs(tonifying qi and nourishing blood)supplemented by drugs for clearing heat and promoting dampness and promoting blood circulation.Among the prescriptions for hyperthyroidism complicated with leukopenia,the most commonly used medicine is drug to increase immunity,and the proportion of which is as high as66.34%.2.2 Analysis of the law of TCM treatmentTCM complex relationship analysis system are used in order to analysize496rmedical records.Based on the correlation of "disease-drug-syndromes-prescription",the basic law of diagnosis and treatment of hyperthyroidism in Chinese medicine was initially drawn.The results are as follows:(1)The distribution of main syndrome types in different course of disease is different.(2)In the course of disease<1 year group,the core drugs include Radix Ginseng,Radix Rehmanniae,Bupleurum,Glycyrrhiza uralensis,Paeonia Alba,Poria cocos,Forsythia forsythia,stir-fried Gardenia jasmine,etc.;the core prescription is Ziyin Qianyang hyperthyreosis prescription(self-made prescription)and Danzhi Xiaoyao powder,and the main syndrome types are yin deficiency and yang hyperactivity and liver stagnation and spleen deficiency.(3)In the course of 1-3 years group,the core drugs include Poria cocos,Pinellia ternata,Forsythia forsythia,Magnolia officinalis,Ligustrum lucidum,Huoxiang,Radix Rehmanniae,scrophularia,Ophiop,etc.;the core prescriptions are Huopu Xialing decoction and Renpu Xuanmai Licorice and Platycodon decoction(self-made prescription).(4)In the course of>3 years group,the core drugs used are Radix Ginseng,Poria cocos,Ophiopogon,alisma,Astragalus membranaceus,Schisandra chinensis,Polygala Sinensis,Ligusticum Chuanxiong,Rehmannia officinalis,Caulis Spatholobi,etc.;the core prescription is Shenqi Dihuang decoction and Shengmai Powder;the main syndrome type is deficiency of Qiyin Liangxu.2.3 Conclusion:Clinical cross-sectional survey findings:(1)Hyperthyroidism occurs in 30-40-year-old women,and the onset of hyperthyroidism is related to physique,mainly caused by physical fatigue and depression.(2).In recent years,the incidence of hyperthyroidism is on the rise,recurrence of patients is also more,and hyperthyroidism prone to recurrence can not be ignored.(3).The most common manifestations in hyperactive patients are neck swelling and discomfort,panic,irritability,fear of heat,sweating,palmar heat,tremor,insomnia,swelling pain,neck sclerosing,etc.Tongue red or thin white coating is the most common clinical tongue image.Fast pulse and chordal vesicles are common pulse patterns in clinical practice.The main adverse reactions of antithyroid drugs from high to low were liver damage,leukopenia,pruritus and gastrointestinal reaction,arrhythmia,leukopenia and liver damage were the most common complications.(4).The five main types of hyperthyroidism are summed up,of which the core syndrome is yin deficiency causing fire.(5).The distribution of syndrome type was correlated with hormone level:the le-vel of thyroid hormone was the highest and the level of TSH was the lowest.Based on the correlation of "disease-drug-syndromes-prescription",the basic law of diagnosis and treatment of hyperthyroidism in Chinese medicine was initially drawn.(1)Five kinds of prescriptions for hyperthyroidism were summarized.(2)Six commonly used drugs for hyperthyroidism complicated with arrhythmias are summed up.(3)The basic treatment rule of hyperthyroidism in Chinese medicine staging.①In the early stage of disease(course of disease<1 year),the core drugs include Radix Ginseng,Radix Rehmanniae,Bupleurum,Glycyrrhiza uralensis,Paeonia Alba,Poria cocos,Forsythia forsythia,stir-fried Gardenia jasmine,etc.;the core prescription is Ziyin Qianyang hyperthyreosis prescription(self-made prescription)and Danzhi Xiaoyao powder,and the main syndrome types are yin deficiency and yang hyperactivity and liver stagnation and spleen deficiency.② In the middle of the disease(course of disease 1-3 years),the core drugs include Poria cocos,Pinellia ternata,Forsythia forsythia,Magnolia officinalis,Ligustrum lucidum,Huoxiang,Radix Rehmanniae,scrophularia,Ophiop,etc.;the core prescriptions are Huopu Xialing decoction and Renpu Xuanmai Licorice and Platycodon decoction(self-made prescription)③ In the later stage of disease(course>3 years),the core drugs used are Radix Ginseng,Poria cocos,Ophiopogon,alisma,Astragalus membranaceus,Schisandra chinensis,Polygala Sinensis,Ligusticum Chuanxiong,Rehmannia officinalis,Caulis Spatholobi,etc.;the core prescription is Shenqi Dihuang decoction and Shengmai Powder;the main syndrome type is deficiency of Qiyin Liangxu.