| Research purpose:Syndrome research summarizes the general characteristics of the subtypes of thyroid nodule qi stagnation and phlegm obstruction syndrome through frequency statistics and cluster analysis of clinical indicators,four diagnostic data,and prescription drug data,and analyzes the medication characteristics of each cluster.Clinical research aims to evaluate the clinical efficacy and safety of the Liqi Huatan Sanjie Formula in treating thyroid nodules with qi stagnation and phlegm obstruction syndrome by observing the changes in the maximum diameter of nodules and traditional Chinese medicine syndrome scores of patients who take the Liqi Huatan Sanjie Formula.This provides a basis for the clinical application of traditional Chinese medicine in the treatment of thyroid nodules.Research methods:Syndrome research:From December 2021 to October 2022,a total of 120 patients with thyroid nodules diagnosed by thyroid ultrasound and diagnosed with qi stagnation and phlegm obstruction syndrome in traditional Chinese medicine were included in the outpatient clinic of the Endocrinology Department of Guang’anmen Hospital.Collect general information(gender,age,body mass index),four diagnostic data(symptoms,physical signs,tongue picture,pulse picture),auxiliary examination(size,quantity,shape,nature,internal echo,edge,presence or absence of calcification,aspect ratio,etc.),and prescription drug data of thyroid nodule qi stagnation phlegm obstruction syndrome through clinical case data collection.Frequency statistics and cluster analysis of the above data are conducted,Summarize the clinical characteristics of thyroid nodules with qi stagnation and phlegm obstruction syndrome.Clinical research:from July 2022 to October 2022,among the outpatients who visited the Endocrinology Department of Guang’anmen Hospital of the China Academy of Chinese Medical Sciences,124 patients who were diagnosed as thyroid nodules by thyroid ultrasound and qi stagnation and phlegm stagnation syndrome by TCM syndrome were selected and randomly divided into two groups according to the random number table,of which 62 patients in the test group were treated with Liqi Huatan Sanjie Decoction,and 62 patients in the control group were treated with traditional Chinese patent medicines and simple preparations Prunella vulgaris Tablets,The course of medication intervention is 12 weeks,and the changes in traditional Chinese medicine clinical syndrome scores,maximum diameter of nodules,thyroid function values,thyroid autoimmune antibody values,and related safety indicators before and after treatment were observed in both groups.SPSS 26.0 was used for statistical analysis of the relevant data.Research conclusion:Syndrome research:Statistical analysis was conducted on the clinical data of 120 patients with thyroid nodule qi stagnation and phlegm obstruction syndrome.The clinical distribution of patients with thyroid nodules with qi stagnation and phlegm obstruction syndrome is significantly higher in females than in males,with 82 cases in females(68.3%)and 38 cases in males(31.6%).The age group distribution is middle-aged group>young group>elderly group.The proportion of patients in the middle-aged group is the highest in 51 cases(42.5%),followed by 40 cases(33.33%)in the young group,and the proportion in the elderly group is the lowest in 29 cases(24.2%).There are 74 patients(61.67%)with normal BMI index of thyroid nodules due to qi stagnation and phlegm obstruction syndrome,35 patients(29.17%)with overweight,8 patients(6.67%)with obesity,and 3 patients(2.5%)with weight loss.The proportion of patients with BMI index within the normal range is relatively large.High resolution ultrasound images of the thyroid gland are mostly characterized by benign signs,with multiple nodules mainly solid and cystic.There are 65 solid nodules,accounting for 54.17%of the total cases,47 cystic solid nodules,accounting for 39.17%of the total cases,and 8 cystic nodules,accounting for 6.67%of the total cases;There is no difference in size distribution;Most nodules have regular boundaries,aspect ratio ≤1,and no microcalcifications.TI-RADS classification is mainly divided into three categories,with 79 cases of low echo nodules(65.83%),41 cases of other echo nodules(34.17%),97 cases of multiple nodules(80.83%),23 cases of single nodules(19.17%),101 cases of regular boundary nodules(84.17%),19 cases of irregular boundary nodules(15.83%),98 cases of nodules with aspect ratio ≤1(81.67%),and 22 cases of nodules with aspect ratio>1(18.33%),There were 107 nodules without microcalcifications(89.17%),13 nodules with microcalcifications(10.83%),101 cases(84.17%)classified by TI-RADS as three main types,113 cases(94.17%)below three types,5 cases(4.17%)in four types,and 2 cases(1.67%)in five types.The top 10 symptoms with the highest frequency of data analysis in the four diagnostic tests were throat foreign body sensation 98 times(81.6%),irritability 73 times(60.8%),neck distension 62 times(51.7%),chest tightness 58 times(48.3%),phlegm 57 times(47.5%),Shantaixi 53 times(44.2%),chest and hypochondriac distension 52 times(43.3%),moss white and greasy 49 times(40.8%),breast distension 47 times(39.2%),and narcolepsy 46 times(38.3%).Through clustering spectrum,they can be divided into six subtypes,The first type is characterized by qi stagnation and phlegm obstruction,which is manifested by the inversion of qi mechanism.The second type is characterized by qi stagnation and phlegm obstruction,which transforms into fire,and internal disturbance of phlegm heat.The third type is characterized by qi stagnation and phlegm obstruction,with a focus on liver qi stagnation.The fourth type is characterized by qi stagnation and phlegm obstruction,with a focus on spleen deficiency and phlegm obstruction.The fifth type is typical of female liver qi stagnation,and the sixth type is characterized by cervical anterior phlegm qi obstruction.The top 10 traditional Chinese medicines with the highest frequency of prescription data analysis are Pinellia ternata 77 times(64.2%),Fritillaria thunbergii 70 times(58.3%),Magnolia officinalis 56 times(46.7%),Forsythia suspensa 53 times(44.2%),Poria cocos 52 times(43.3%),Dandelion 46 times(38.3%),Sagittaria scoparia 44 times(36.7%),Atractylodes macrocephala 43 times(35.8%),Bombyx mori 40 times(33.3%),and Glycyrrhiza uralensis 39 times(32.5%).Through cluster lineage diagrams,they can be divided into four categories.The first category is to regulate qi and phlegm,to soothe the liver and strengthen the spleen,The second type is mainly based on Banxia Houpu Tang,the third type is mainly based on Sanjie Xiaoying specialized medicine,and the fourth type is mainly based on Junyao and the main medicine Banxia,with a higher frequency of occurrence.Clinical research:1.This study involved 5 cases of dropout,with a total of 119 subjects observed.There were 59 cases in the experimental group and 60 cases in the control group.2.General data comparison:There was no statistically significant difference in gender,age,and course of disease between the two groups of subjects before treatment(P>0.05).3.Comparison of Traditional Chinese Medicine Efficacy:The total effective rate of syndrome improvement in the experimental group was 93.2%,while the total effective rate of syndrome improvement in the control group was 48.3%.There was a statistical difference between the two groups(P<0.05),indicating that the experimental group was significantly better than the control group in improving the clinical symptoms of thyroid nodule qi stagnation and phlegm obstruction syndrome.4.Comparison of total points of traditional Chinese medicine syndromes:Before and after treatment,the two groups were compared within and between groups.Through corresponding treatment,the total points of both groups were lower than before treatment,with statistical significance(P<0.05);The comparison between groups indicates that the experimental group is significantly better than the control group in improving clinical symptoms of traditional Chinese medicine(P<0.05).5.Comparison of therapeutic effects of Western medicine:The effective rate of the experimental group was 67.8%,while the effective rate of the control group was 36.7%(P<0.01),showing a statistically significant difference.This indicates that the experimental group is significantly better than the control group in reducing the maximum diameter of thyroid nodules.6.Comparison of efficacy in reducing the maximum diameter of nodules:The efficacy of the experimental group was compared before and after treatment(P<0.01),and the difference was clinically statistically significant,indicating that the maximum diameter of nodules in the experimental group improved significantly after treatment compared to before treatment;There was no clinically significant difference in the efficacy of the control group before and after treatment(P>0.05),indicating that the maximum diameter of the nodules in the control group did not improve significantly after treatment compared to before.7.Comparison of thyroid function and autoimmune antibodies:During the experiment,all indicators were within the normal range,and there was no significant difference(P>0.05).8.During the experiment,neither group of subjects experienced any adverse reactions,and safety indicators such as blood routine,urine routine,liver function,and kidney function were within normal ranges before and after treatment.The Li Qi Hua Tan San Jie Fang has significant clinical efficacy and high safety in treating thyroid nodules with Qi stagnation and phlegm obstruction syndrome.It has obvious advantages in improving traditional Chinese medicine syndromes,effectively reducing the size of thyroid nodules,and has high drug safety without any adverse reactions.It is worth further exploration and application in clinical practice. |
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