Professor Liu Ximing's Study On The Treatment Of Hyperthyroidism In The Elderl

ObjectiveTo analyze the characteristics of clinical symptoms and pathogenesis of hyperthyroidism in the elderly,and to summarize the characteristics of clinical medication and the ideas of formulae used by our supervisor Professor Ximing Liu in the treatment of hyperthyroidism in the elderly,in order to provide a theoretical basis for the treatment of hyperthyroidism in the elderly by Chinese medicine.Methods1.Study subjects:elderly patients with hyperthyroidism who met the inclusion and exclusion criteria of the study from January 2017 to December 2022.2.Study method:information on geriatric hyperthyroidism was extracted from Professor Liu Ximing’s outpatient medical record system,and the data were standardized and entered into the geriatric hyperthyroidism database.The data of gender,duration of disease,type of hyperthyroidism,clinical symptoms,TCM symptoms,treatment and prescriptions were statistically and analytically analyzed.3.Statistical methods:descriptive statistical analysis was performed on the count data(gender,duration of illness,type of hyperthyroidism,clinical symptoms,TCM symptoms and treatment methods,etc.),and the frequency and frequency of each category were counted separately;correlation and cluster analysis were performed on the count data(TCM);statistical analysis of the maximum,minimum and mean values were performed on the measurement data(TCM dose).Results1.General data:97 elderly patients with hyperthyroidism were included,including 77 females and 20 males,with a male to female ratio of 1:3.85;54 patients with indifferent hyperthyroidism and 43 patients with common hyperthyroidism.The disease duration was mostly 1～5 years,82 cases with comorbidities,and 64 cases without anti-hyperthyroid drugs.2.Distribution of symptoms:The more frequent symptoms were insomnia(55.67%),palpitations(53.61%),impatience and irritability(50.52%),fatigue(30.93%),and excessive sweating(26.80%)in that order.Among them,indifferent hyperthyroidism mainly manifested as insomnia,palpitation,weakness,loss of appetite and weakness of lower limbs;common hyperthyroidism mainly manifested as impatience and irritability,palpitation,insomnia,excessive sweating and weight loss.3.TCM symptoms:TCM symptoms are mainly heart-liver yin deficiency(28.87%),liver-kidney yin deficiency(28.87%),heart-liver fire(18.56%),and phlegm-heat interconnection(9.28%).4.Chinese medical treatment:Chinese medical treatment mainly consisted of benefiting Qi and nourishing Yin(28.87%),clearing the heart and dipping the liver(11.34%),nourishing Yin and tonifying the kidney(9.28%),and clearing heat and resolving phlegm(9.28%),etc.5.Medication characteristics:172 prescriptions were included,involving a total of 136 types of Chinese medicines.The more frequently used herbal medicines were,in order:Shu Di Huang(45.35%),Mai Dong(42.44%),Shan Yao(37.21%),Lily(25.00%),Cornus officinalis(24.42%),Fried Sour Date Palm(24.42%),Dendrobium(22.67%),Bei Sha Shen(21.51%),Huang Lian(20.35%),Zhi Mu(19.19%).6.Association clustering:Using association analysis,the core combinations of the drug pairs were Shu Di Huang-Cornu Cervi Pantotrichum,Shu Di Huang-Yam,Cornu Cervi Pantotrichum-Yam,and Bei Sha Shen-Mai Dong.Using cluster analysis,the core combinations are:Dendrobium+Radix Rehmanniae+Cornu Cervi Pantotrichum+Cornu Cervi Pantotrichum,Fried Date Palm+Huang Lian,Mai Dong+Zhi Mu+Lily+Bei Sha Shen.7.The characteristics of medications used in different symptoms:for heart-liver yin deficiency symptoms,Mai Dong,Bei Sha Shen,Lily,fried date palm and Shan Yao are commonly used;for liver-kidney yin deficiency symptoms,Shu Di Huang,Shan Yao,Mai Dong,Cornus officinalis and Dendrobium;for heart-liver fire symptoms,Huang Lian,Che Qian Zi,Scutellaria,Gentian and Poria;for phlegm-heat interlocking symptoms,Huang Lian,Zhe Bei Mo and Curcuma are commonly used.Conclusion1.The characteristics of hyperthyroidism in the elderly are:female prevalence,clinical insidiousness,multi-disease complications,and complex intertwining.2.The pathogenesis of hyperthyroidism in the elderly:deficiency of yin and essence.The TCM symptoms are mainly yin deficiency with fire-heat,and yin deficiency is even worse in indifferent hyperthyroidism.3.The location of hyperthyroidism in the elderly:kidney-based,involving liver and heart.4.4.Treatment of hyperthyroidism in the elderly:nourishing Yin is the first priority,and clearing heat is supplementary.Emphasis is placed on nourishing the spleen,stomach,liver and kidney.5.Medication for hyperthyroidism in the elderly:Chinese herbal medicines are commonly used to nourish Yin and tonify the kidneys,and the commonly used formulae follow the method of Liu Wei Di Huang Wan and Mai Men Dong Tang.