The Study On The Disease Classification And TCM Syndrome Of Hyperthyroidism

ObjectiveBased on 119 cases of hyperthyroidism patients gender,age,onset time,course of disease,nationality,family history,TCM syndromes and TCM medications were analyzed,the study focuses on the distribution of syndromes pattern and the trait of TCM medications,and provides effective help for the differentiation and the Chinese medicine treatment.MethodsAccording to diagnosis standard of hyperthyroidism,collecting a total of hyperthyroidism patients 119 cases in endocrinology department of the First Affiliated Hospital of Guangzhou.According to the the research contents,119 cases were divided and collected the diseases of general information,syndromes and TCM medications.The data were sorted into Stata 13.0 and SPSS 17.0 standard database and were analyzed.According to the factor analysis and Logistic regression analysis on the TCM syndromes and drug use.ResultsIn this study,there were 29 males and 90 females,women accounted for 75.63%.The minimum 4 years and the maximum 73 years old.There were 6 patients under 15 years,46 patients 16 to 30 years,31 patients 31 to 45 years,36 patients 46 to 73 years,accounted for 5.04%,38.66%,26.05%and 30.25%.There were 96 patients from Guangdong(80.67%),7 patients from Hunan,4 patients from Guizhou,3 patients from Guangxi,2 patients from Hubei,Anhui,Henan,1 patients from Jilin,Yunnan and Fujian.There were 26 cases in spring,accounting for about 21.85%.There were 7 cases in the spring equinox Guyu accounting for 5.88%of the total cases,followed Lichun(4 cases,3.36%),Qingming(4 cases,3.36%),Jingzhe(3 cases,2.52%),Yushui(1 case,0.84%);there are 37 cases in summer accounting for 31.09%.Different solar term incidence from the order as:Lixia(10 cases,8.40%)>Mangzhong(9cases,7.56%)>Xiaoman(7cases,5.88%)>Xiaoshu(6cases,5.04%)>Dashu(3cases,2.62%)>Xiazhi(2 cases,1.68%).There were only 25 cases in autumn accounting for 21.01%.The number of Chushu the highest incidence of a total of 10 cases,accounting for 8.40%,Liqiu and Bailu were 5 cases(4.20%),Qiufen and Shuangjiang 2 cases(1.68%),Hanlu 1 cases(0.84%).There were 31 cases in winter accounting for 26.05%.The highest incidence of solar term for Daxue,there were 11 cases(9.24%),followed by Lidong(10 cases,8.40%),Dahan(5 cases,4.20%),Dongzhi(3 cases,2.62%),Xiaoxue(1 cases,0.84%)and Xiaohan(1 cases,0.84%).There were 85 cases less than 1 years(71.43%),17 cases 1 to 6 years(14.29%),14 cases 6 to 12 years(11.76%),3 cases more than 12 years(2.52%).There were 21 cases who have a family history(17.56%).Patients with hyperuricemia were 19 cases(15.97%),9 cases of abnormal liver function(7.56%),4 cases of hypertension and diabetes(3.36%),3 cases abnormal glucose tolerance and rheumatoid arthritis(2.52%).There were 96 cases with thyroid enlargement(80.67%),67 cases were Ⅱ,Ⅰ and Ⅲ were 19 cases.Other tests such as eye tremor syndrome,hand tremor experiment and exophthalmos were 32,18 and 20 cases,accounting for 26.89%,15.13%,16.81%.Normal menstruation in 25 cases,41 cases of abnormal menstruation.There are 48 cases of Syndrome of spleen kidney deficiency(40.34%),36 cases of Syndrome of liver fire exuberance(30.25%),17 cases of Syndrome of Qi and yin deficiency(14.29%),9 cases of Syndrome of liver qi stagnation and phlegm and Syndrome of yin deficiency of xin-gan(7.56%).Hyperthyroidism patients with Syndrome of deficiency of spleen and kidney are spleen and kidney qi deficiency as the main clinical manifestations,such as loss of appetite,fatigue,thirst without desire to drink,shortness of breath,aversion to cold,loose stool,frequent urination,dark pale tongue,thick white fur or greasy,deep thready pulse.Patients with Syndrome of liver fire exuberance are mainly perturbation suffered on neck,such as heat and sweating,tachycardia,irritability,dry mouth to drink,eat easy to hunger,red tongue,moss thin yellow or yellow and greasy,wiry and rapid or taut and slippery pulse.Patients with Syndrome of Qi and yin deficiency are the heart qi deficiency and yin deficiency syndrome as the main clinical manifestations,such as palpitation,hunger and no desire to eat,tachycardia,poor sleep,fatigue,red and moss tongue,rapid pulse.Patients with Syndrome of yin deficiency of xin-gan with heart Yin Huo Wang steam in the neck as the main clinical manifestations,such as palpitation,sweating,heat intolerance eat easy to hunger,fatigue,dry mouth and do not want to drink,red and less mossy tongue,rapid pulse.Patients with Syndrome of liver qi stagnation and phlegm with gas condensation on the neck,and discomfort as the main performance,mainly for cervical enlargement,loss of appetite,thirst,heat and sweating,insomnia,irritability,pale tongue,mossy white or white greasy,small and wiry pulse.The syndrome factors of hyperthyroidism mainly relate to dampness,phlegm,heat,Qi deficiency,yin deficiency,the main disease in heart,liver,spleen,kidney and stomach.Factor analysis of the three syndromes are spleen kidney deficiency of heart qi deficiency syndrome,phlegm heat and blood stasis syndrome,liver yin deficiency syndrome.The Syndrome of deficiency of spleen and kidney mainly use 20 species traditional Chinese medicine which 47 cases are using Atractylodes,Zhigancao(97.92%).The Syndrome of liver fire exuberance mainly use 21 kinds and 31 cases use Radix Bupleuri(96.88%).The Syndrome of Qi and yin deficiency mainly use in 22 species,using Zhigancao the largest proportion(82.35%).Ophiopogon japonicus,Radix Codonopsis,Atractylodes macrocephala and Schisandra chinensis are used in more than 40%.The Syndrome of yin deficiency of xin-gan mainly use 21 kinds.In addition to the use of Zhigancao,drug frequency of more than 50%of the oysters,figwort,Ophiopogon japonicus.The Syndrome of liver qi stagnation and phlegm mainly use 15 kinds,including Codonopsis,Poria,Atractylodes,licorice root,pinellia tuber rate more than 50%.Logistic regression analysis showed that the drug for Syndrome of the deficiency of spleen and kidney as monkshood,alismatis,adenophora stricta,the OR values are 38.46,29.19 and 9.48.The drugs for Syndrome of liver fire exuberance is bupleurum,its OR value is 156.55.The drug for Syndrome of Qi and yin deficiency is the radix,the OR value is 12.71.The drug for Syndrome of yin deficiency of xin-gan is radix scrophulariae,the OR value is 6.417;the drug for Syndrome of liver qi stagnation and phlegm is elecampane,its OR value is 23.ConclusionThe results of this study found that:The patients with hyperthyroidism are more common 16 to 45 years old women,more than in the summer and winter seasons,relates to five types including Syndrome of spleen kidney deficiency,Syndrome of liver fire exuberance,Syndrome of Qi and yin deficiency,Syndrome of liver qi stagnation and phlegm and Syndrome of yin deficiency of xin-gan,and gives priority to the Syndrome of spleen kidney deficiency.The syndrome factors mainly relate to dampness,phlegm,heat,Qi deficiency and yin deficiency,the main disease of heart,liver,spleen,kidney and stomach,factor analysis of the three syndromes are spleen kidney deficiency of heart qi deficiency syndrome,phlegm heat and blood stasis syndrome,liver yin deficiency syndrome.In the treatment of traditional Chinese medicine,different types of syndromes using different traditional Chinese medicine,mainly including smoothing qi,warming the spleen and kidney,Qi and Yin drugs.