| Objective:By analyzing the relationship between Traditional Chinese Medicine(TCM)syndrome differentiation in patients with Thyroid nodule(TN)and ultrasound features in the Thyroid Imaging Reporting and Data System(TI-RADS),the correlation between ultrasound features in patients with TN and TCM syndrome differentiation was explored.Methods:By collecting and sorting out the relevant data of 396 patients who were found TN under thyroid color ultrasonography in the outpatient and inpatient departments of the Department of Cardiovascular Endocrinology of Kunming Hospital of Traditional Chinese Medicine from December 2019 to December 2020,the TCM syndrome differentiation of396 patients was conducted.According to the 2017 edition of American College of Radiology(ACR)TI-RADS scoring standard,five ultrasonic characteristics of TN,including composition,echo,morphology,margin and calcification,were collected and sorted out.To analyze the relationship between TCM syndrome differentiation and ultrasonic characteristics,TI-RADS classification,and draw a correlation conclusion.Results:1.A total of 396 cases were included in the study,including 131 cases(33.1%)of qi stagnation and phlegm obstruction syndrome,109 cases(27.5%)of phlegm coagulation and blood stasis syndrome,70 cases(17.7%)of phlegm fire stagnation syndrome,and 86 cases(21.7%)of qi and Yin deficiency syndrome.In terms of gender,142 cases were male(35.9%)and 254 cases were female(64.1%).The ratio of male to female was 1:1.789.The detection rate of female TN was higher than that of male.In terms of age,elderly patients accounted for the largest proportion,accounting for 60.6%.There was no statistical significance in gender and age among the four groups(P>0.05).2.There was no statistical significance in nodular composition among the four groups(P>0.05).3.There were statistically significant differences in nodule echo and calcification among the four groups(P<0.05): pair comparison:(1)the detection rate of low echo and very low echo in the spittoon coagulation and blood stasis syndrome group was higher than that in the other three groups,and the difference was statistically significant(P<0.05);(2)The detection rate of marginal calcification and microcalcification in the spittoon coagulation and blood stasis group was higher than that in the phlegm fire stasis group and the qi-yin deficiency group,and the difference was statistically significant(P<0.05).4.There were statistically significant differences in the shape and edge of nodules among the four groups(P<0.05).Among them,pair-wise comparison:(1)the detection rate of aspect ratio ≥1 in the qi-stagnation and phlegm obstruction syndrome group was higher than that in the other three groups,with statistically significant differences(P<0.05);(2)The detection rate of edge angulation or irregularity in qi stagnation and phlegm obstruction syndrome group was higher than that in the other three groups,with statistical significance(P<0.05).5.There was no statistical significance in ACR TI-RADS grade 2-5 among the four groups(P>0.05).Conclusion:1.The detection rate of female TN was higher than that of male.2.The higher the age,the higher the detection rate of TN.3.TN sonographic features described in the echo,calcification,shape,edge associated with four types of TCM syndrome types:(1)the echo score higher in low echo,extremely low echo,and calcification score higher in the edge of calcification,microcalcification detection rate in patients with Tan Ning blood stasis were the highest,that of kunming region Tan Ning TN of blood stasis syndrome patients tend to undergo malignant TN,in the future need to pay close attention to echo and calcification in thyroid colour to exceed characteristics change;(2)Morphological aspect ratio ≥1 with a higher score,and marginal angulation or irregularity with a higher score had the highest detection rate in patients with qi-stagnation phlegm obstruction syndrome.It is speculated that TN patients with qistagnation phlegm obstruction syndrome in Kunming area will have a tendency to develop malignant TN in the future,and it is necessary to pay close attention to the changes of morphology and marginal characteristics in thyroid color ultrasound.4.There was no statistical significance between the TCM syndromes of the four groups and ACR TI-RADS grades 2-5.Since the score determination of TI-RADS grading was obtained by the addition of five characteristic scores,the score of any one of them may affect the research results.Therefore,the four groups of TN patients with syndromes in this study are all at risk of developing malignant TN.Based on the results of this study,it can be inferred that TN patients with the syndrome of phlegm stagnation and blood stasis and qi stagnation and phlegm obstruction have a tendency to develop malignant TN in the future.Therefore,TCM syndrome differentiation can be applied for intervention and treatment in advance to reduce or even block the development of TN to malignant lesions.5.In terms of TCM syndrome differentiation of TN patients,this study provided TIRADS ultrasonic characteristic data research and analysis related to it,and also provided a reference basis for syndrome differentiation treatment in clinical practice,which is of great significance for judging the development and prognosis of TN. |
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