Hyperthyroidism Merger Of Liver Damage 85 Cases Clinical Data And Medical Certificate To Law Is Analyzed

Objective:Analyse the reason, degree, type and related used drugs of liver injury and explore the law of TCM syndrome differentiation and treatment, in order to provide reference for further clinical diagnosis and treatment.Methods:Collect 85 hospitalized patients(male 26 cases, female 59 cases) of hyperthyroidism in the Affiliated Hospital of Nanjing University of Chinese Medicine from 2007 to 2011. Take the case control study, analyse hospital admission rates and liver injury degree, collect the alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALK), r-glutamyl transferase (r-GT) and total bilirubin (Tbil), direct bilirubin (Dbil), indirect bilirubin (Tbil), TCM syndrome type, the use of traditional Chinese medicine and the law of TCM syndrome differentiation and treatment.Results:1. Hyperthyroidism patients with liver damage accounted for four years, the proportion of hospitalized over the same period of hyperthyroidism increases every year, rising from 7.4 percent in 2007 to 19.8% in 20112.85 cases clinical retrospective analysis show:hyperactivity of heart-liver fire type, hyperactivity of yang due to yin deficiency type and phlegm fire internal disturbance type are the common types of hyperthyroidism with liver damage, accounted for 55.29%,29.41% and 15.29% orderly. The average days in hospital of 85 patients was 11.56. The days of hyperactivity of heart-liver fire type returned to normal after the traditional Chinese and western medicine treatment was 9.24.The ALT, r-GT and TBIL of phlegm fire internal disturbance type were raised the most obviously among the three types(P<0.05). At the aspect of TCM symptoms accumulated points, the hyperactivity of heart-liver fire type descended the most obviously.3 liver injury situation:combining traditional Chinese and western medicine treatment, the Chinese Medicines average treatment day number for 9.45 days, a simple western medicine group therapy an average day number for 11.67 days, hyperthyroid liver damage average treatment days, the number of eight days, drug-induced liver damage average treatment was 8.5 days. TCM group than in the average number of days the only western group(P<0.05).4. Statistic the clinical common Chinese medicine in 71 patients who take. Selfheal, tuckahoe, astragalus, forsythia, root of herbaceous peony, liquorice, fritillaria thunbergiiwere and so on, the frequency show:clear away heat class kinds> tonify deficiency kinds> induce diuresis to drain dampness kinds> resolve phlegm kinds> regulate Qi kinds. Combined with herbs and using category, statistical results indicate: the uses of clearing away the heat evil and expelling superficial evils, supplementing qi and nourishing yin, inducing diuresis to drain dampness are very important.5. Hyperthyroid liver injury and drug-induced liver injury of the features: hyperthyroidism, liver injury ALT and AST were higher than drug-induced liver injury group (P<0.05) was statistically significant, suggesting that the hyperthyroid liver damage compared to drug-induced liver injury compared to spectrum to hepatic enzyme increased mainly drug-induced liver injury ALP, r-GT, TBLL were higher than the hyperthyroid liver injury group (P<0.05), suggesting that drug-induced liver injury mainly to the spectrum of biliary tract enzymes increased and cholestasis based.Conclusion:1. The liver injury become one of the main complication of hyperthyroidism. Drugs induced liver injury is most serious and hyperthyroidism induced liver injury is the most common.2. Hyperactivity of heart-liver fire type is most common in hyperthyroidism with liver injury, such as in the foundation of treatment combined with Chinese medicine can improve liver injury degree and can shorten the treatment time.