Professor Ma Jian’s Research And Experience Summary Of Traditional Chinese Medicine In The Treatment Of Hashimoto’s Thyroiditis Complicated With Hypothyroidism

Objective:The medical records of patients with Hashimoto’s thyroiditis and hypothyroidism diagnosed in clinic were collected,and Professor Ma Jian’s traditional Chinese medicine medication rules in the treatment of Hashimoto’s thyroiditis and hypothyroidism were analyzed,and the clinical treatment experience was summarized and passed on.Methods:The medical records of patients with Hashimoto’s thyroiditis and hypothyroidism who were diagnosed with Hashimoto’s thyroiditis and hypothyroidism at the outpatient clinic of Professor Ma Jian of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from January 2017 to December 2020 were collected.After sorting and analysis,140 medical records of Hashimoto’s thyroiditis combined with hypothyroidism who met the inclusion criteria were screened out.The selected medical records were entered into the Traditional Chinese Medicine Inheritance Computer System(TCMICS)one by one.Statistical analysis was carried out on the general information of patients,the frequency of use of traditional Chinese medicine,the four qi and five flavors,the meridian,the mode of traditional Chinese medicine medication,clustering characteristics,and core prescriptions.This paper analyzes Professor Ma Jian’s traditional Chinese medicine medication rules in the treatment of Hashimoto’s thyroiditis complicated with hypothyroidism,and summarizes the clinical treatment experience and academic thoughts.Result:1.Among the 140 medical records,130(92.86%)were female patients and 10(7.14%)were male patients.2.The age of patients was concentrated between 30-59,accounting for65.71%.3.There were 11 kinds of tongue images in the patients,with red tongue(132 times),white tongue coating(111 times),and dentate tongue(81 times),accounting for 79.22%.4.There were 14 kinds of pulse patterns in the patients,the main ones were stringy and slippery(44 times),slow pulse(23 times),and slippery pulse(22 times),accounting for 63.57%.5.There are 95 kinds of symptoms in patients,of which the symptoms with frequency greater than 15 include fatigue,hair loss,first-degree thyroid enlargement,chills and drowsiness.6.There are 42 kinds of medicines with more than 10 application frequency of traditional Chinese medicine,accounting for 90.00%.7.The four qi of traditional Chinese medicine were dominated by 1123times(40.37%)of warm nature,788 times(28.32%)of cold nature,530 times(19.05%)of flat nature and 279 times(10.03%)of heat nature,accounting for97.77%.8.Among the five flavors of traditional Chinese medicine,bitter taste was 1632 times(34.72%),pungent taste was 1425 times(30.32%)and sweet taste was 1279 times(27.21%),accounting for 92.26%.9.The spleen meridian,lung meridian,heart meridian,liver meridian,kidney meridian and stomach meridian whose frequency was more than 500 times accounted for 90.24%.10.The efficacy of traditional Chinese medicine is mainly tonic 774 times,clearing heat 399 times,regulating qi 315 times,warming 283 times,resolving phlegm,relieving cough and relieving asthma 280 times,promoting blood circulation and removing blood stasis 258 times,and diuretic dampness188 times.The percentage is 89.76%.11.The association analysis set the support degree to 110 and the confidence degree to 1,and obtained 248 drug combinations and 78 association rules.The core prescriptions are Atractylodes,Astragalus,Ginger,Poria,dried tangerine peel,Aconite,Paeonia lactiflora,Prunella,Campanulaceae,Angelica.12.The k-means algorithm derives six core combinations,the first group: Prunella vulgaris,dried ginger,Platycodon grandiflorum,Atractylodes,dried tangerine peel,Poria,Baishao,Qingpi(43 times);the second group:Astragalus,Poria,dried ginger,Atractylodes,Aconite,Bai Shao,Chenpi,Platycodon grandiflorum(43 times);the third group: dried ginger,Atractylodes,Astragalus,Poria,Aconite,Chenpi,Baishao,Bupleurum(19times);the fourth group: Atractylodes,Chenpi,Poria,Aconite,dried ginger,Paeonia lactiflora,Astragalus,Prunella(14 times);Fifth group: Poria,aconite,dried ginger,Paeonia lactiflora,Atractylodes,dried tangerine peel,Astragalus,Pinellia(12 times);Sixth group: Xia Subtilis,Poria,Aconite,Dried Ginger,Angelica,Atractylodes,Astragalus,Alisma(9 times).Conclusion:1.When Professor Ma Jian treated Hashimoto’s combined hypothyroidism,the most frequently used drug was Atractylodes.The four qi of medicine are mainly warm,cold,flat and hot.The five flavors are mainly bitter,pungent and sweet.The main channels are the spleen,lung,heart,liver,kidney and stomach.2.Professor Ma Jian’s core prescriptions for treating Hashimoto’s combined with hypothyroidism are Atractylodes,Astragalus,dried ginger,Poria,tangerine peel,aconite,white peony,Prunella,Campanulaceae,Angelica.The most commonly used medicine pair is Atractylodes-Ginger.3.Professor Ma Jian believes that the pathogenesis of Hashimoto’s combined hypothyroidism is "the interrelation of phlegm,qi and blood,and deficiency of spleen and kidney yang"."Qi,phlegm,blood stasis" runs through the entire course of the disease.4.When Professor Ma Jian treats Hashimoto’s combined hypothyroidism,he pays attention to the combination of disease and syndrome,and takes physical factors into consideration.Dispatching medicines focuses on strengthening and protecting the spleen and soil,and making good use of "cultivating soil to make water" for treatment.5.In the treatment of Hashimoto’s combined hypothyroidism,Professor Ma Jian divided it into three types: liver stagnation and spleen deficiency,spleen yang deficiency,and spleen and kidney yang deficiency.