Integrative Medicine Clinical Subacute Thyroiditis Systematic Review Of Randomized Controlled Trials

Purpose：To evaluate the benefits and harms Traditional Chinese Medicine(TCM) combing with west medicine in patients with subacute thyroiditis（SAT）.Review systematically whether there is enough existing evidencesthat TCM is effective and safe in the treatment of the patients with westmedicine.Methods：1.According to the requisition of systematic evaluation，formulate detailed standardization of the inclusion and exclusioncriteria including the type of research subjects, intervention andoutcome of events.2.According to laying a standardization, we developeda systematic and comprehensive search strategy.Literature were retriev-ed by computerized searching from PubMed (1980-2013), CBM(1979-2013.3),CNKI (1980-2013),and those in Chinese Conference Treatises and Periodalin thyroid disea-se were handed searched.3.We evaluated themethodological quality of the included studies, evaluation item includingthe method of random allocation, concealed sub-blind law and attritionbias in the assessment.Quality of them was evaluated with the methodrecommended,the quality of classification including A,B, C threegrades.4.We collect the relevant research information data after rigorousevaluation of the quality, and mainly collect the incidence of the outcomeof data. Statistical analysis was performed using the CochranceCollaboration’s Rev Man5.2software. Enumeration data use Odds Ratio (OR)manifestates, and measurement data use Weighted Mean Difference(WMD)manifestates, both all preaent95%Confidence Interval (CI). We usechi-square to test the statistical heterogeneity of every study, and madeα=0.1for the size of test. We analyze data using fixed-model while thereis no statistical heterogeneity, otherwise random-model was used.Results：1.This study included a total of17about the Chinese medicinefor treatment of SAT randomized controlled trials, with a total of1023 cases, including473cases of the treatment group,and550patients in thecontrol group, treatment for14-60days.15studies reported symptom scoretreatment efficiency, two studies report changes in thyroid hormonelevels, six research report the time difference of symptoms improving,four research reports the recurrence rate of the follow-up six months.A baseline comparability test was done before the start of the study,andthere were no statistically significant.2.The results of metanalyses:Integrative Medicine total efficiency OR and95%Cl8.08[4.87,13.40],the total effect:Z=8.10, P <0.00001; pain relief time of cervical areaSTD and95%CI-1.27[-1.58,-0.96], the total effect: Z=8.00, P <0.00001;average antifebrile time STD and95%CI-1.31[-1.62,-1.00], the totaleffect Z=8.28, P <0.00001;detoxify method combined with western medicinewith western medicine alone control the efficiency OR and95%Cl0.11[0.06,0.20], the total effect Z=7.54, P <0.00001; reducing swellingcombined with Western medicine with western medicine alone controltreatment efficiency OR and95%Cl were0.15[0.08,0.29], the total effectof Z=5.79, P <0.00001; blood circulation method combined with westernmedicine and western medicine alone control the efficiency OR and95%Clwere0.13[0.06,0.25], the total effect Z=5.98P <0.00001;regulate theflow of vital energy method to combine Western medicine with westernmedicine alone control efficiency OR and95%Cl0.09[0.04,0.20], thetotal effect of Z=5.98, P <0.00001; reduce phlegm combined with Westernmedicine and Western medicine alone treatment were the the efficiency ORand95%Cl0.13[0.06,0.28], the total effect Z=5.15, P <0.0000; relapserate of following-up six months OR and95%Cl-0.22[-0.31-0.13], thetotal effect Z=4.85, P <0.00001.Conclusions：Integrative Medicine subacute thyroiditis, which significa-ntly improve the clinical symptoms and improve the treatment efficiency,reduce the relapse rate, compared with western medicine treatment efficacy. The method of traditional Chinese medicine, detoxify, reducingswelling, blood circulation,regulate the flow of vital energy, and reducephlegm, combined with western medicine treatment, compared with westernmedicine more efficient. But Chinese medicine dialectical theory ofgovernance each card type and governance are not independent, ratheraccording to the patient’s clinical symptoms.The difference between thedialectical unity and the rule need more study. The inclusion of boththe methodological quality of studies exist, the small number of samplesand other limitations, remain to be confirmed.