Based On The NIM Network To Explore The Clinical Efficacy And Mechanism Of The Treatment Of Hashimoto's Disease By The Method Of Clearing The Liver, Strengthening The Spleen And Regulating Qi

1 ObjectiveIn this study,patients with Hashimoto’s thyroiditis with liver stagnation and spleen deficiency were selected as the target group,Qinggan Jianpi Liqi prescription as the treatment plan,thyroid hormone levels,thyroid related antibody levels,TCM syndrome scale,thyroid volume,blood routine,Liver function and kidney function are observation indicators,and systematically evaluate the clinical effectiveness and safety of the therapy;At the same time,by examining ACTH to evaluate the effect of Qinggan Jianpi Liqi method on the balance of HPA axis and auto-inflammatory immune regulation,the mechanism of Qinggan Jianpi Liqi method for the treatment of Hashimoto’s thyroiditis with liver depression and spleen deficiency was initially clarified.2 MethodAccording to the inclusion and exclusion criteria,a total of 84 patients with Hashimoto’s thyroiditis were included,and 2 patients fell off.All subjects were treated with the method of Qinggan Jianpi Liqi method,with a period of 3 months;before and after treatment,the thyroid hormone level,thyroid-related antibody level,TCM syndrome scale,thyroid volume,blood routine,liver function,kidney function,ACTH Titer level.3 Result3.1 Analysis of TPOAb and TGAb titer levels before and after treatmentAfter treatment,the titers of TPOAb and TGAb in 82 subjects were lower than before,and the difference was statistically significant(p<0.05).Subgroup analysis:(1)The levels of TPOAb titers in subjects with normal thyroid function and hypothyroidism decreased significantly after treatment(p<0.05);(2)There was no statistically significant difference in the TPOAb titer level of subjects in the hyperthyroidism group after treatment(p>0.05);(3)The levels of TGAb titers in subjects with normal thyroid function,hypothyroidism and hyperthyroidism decreased significantly after treatment(p<0.05).3.2 Analysis of ACTH titer levels before and after treatmentAfter treatment,the titers of ACTH in 82 subj ects were lower than before,and the difference was statistically significant(p<0.05).Subgroup analysis:(1)The levels of ACTH titers in subjects with hyperthyroidism group decreased significantly after treatment(p<0.01);(2)There was no statistically significant difference in the levels of ACTH titers between subjects with normal thyroid function and hypothyroidism after treatment(p>0,05).3.3 Correlation analysis between ACTH titer level and thyroid autoantibody levelCorrelation analysis of 82 subjects showed that ACTH titer level was positively correlated with TPOAb,but no significant correlation with TGAb.3.4 Analysis of thyroid hormone levels before and after treatment(1)After treatment,in the subjects with hypothyroidism group,the TT3,TT4,FT3 and FT4 were all higher than before,and the TSH decreased(p<0.05),(2)After treatment,in the subjects with hyperthyroidism group,the TT3,TT4,FT3 and FT4 all decreased compared with before,and the TSH increased(p<0.05).3.5 Analysis of thyroid volume before and after treatmentAfter treatment,the volume of the right lobe and the volume of the left lobe showed a trend of shrinkage,with a statistically significant difference(p<0.01).No significant change in the isthmus.3.6 Analysis of TCM Syndrome Scores and TCM Syndrome Effects(1)After treatment,the scores of TCM syndromes of all subjects decreased compared with before,with a statistically significant difference(p<0.01);(2)Analysis of curative effect of TCM syndromes of all subjects:The total effective rate is 94%.3.7 Analysis of Security indexAccording to the safety evaluation criteria,there were 80 cases in grade 1 and 2 cases in grade 3.The safety was 97.56%,and no obvious adverse events occurred.4 Conclusion4.1 Clinical researchTreating Hashimoto’s thyroiditis with the method of Qinggan Jianpi Liqi can reduce the level of thyroid antibodies,improve thyroid function,relieve goiter,and reduce the score of TCM syndromes.This treatment is safe and effective in clinical application.4.2 Mechanism researchNIM networks(such as ACTH)may be one of the potential multi-targets for the treatment of Hashimoto’s thyroiditis with Qinggan Jianpi Liqi.