| OBJECTThrough clinical investigation,the clinical symptoms and signs of Hashimoto’s thyroiditis were collected,and the syndromes distribution of Hashimoto’s thyroiditis were excavated based on statistical analysis.METHODSFrom October 2019～December 2020,the outpatients in the thyroid department of Dongzhimen Hospital of Beijing University of traditional Chinese Medicine,China-Japan Friendship Hospital and the Outpatient Department of Beijing University of Chinese Medicine were selected as the source of the cases.Based on literature research and clinical observation,the questionnaire of TCM syndrome of Hashimoto’s thyroiditis was established.Clinical case information collection,collation and analysis of data.Using Excel 2007 software to input data,SAS12.0 software for statistical analysis,based on frequency statistics,cluster analysis,chi-square test,chi-square trend test,analysis of Hashimoto thyroiditis traditional Chinese medicine syndrome characteristics,as well as syndrome and age,course of disease,thyroid function correlation.RESULTS1.Basic information and dataThere were 350 HT patients,340(97.14%)in women,and 10(2.86%)in men.Patients ranged from 18 to 70 years,with an average age of 41.86 ± 12.40 years,18 to 30,31 to 40,41 to 50,51 to 60,61 to 70 years,71(20.29%),115(32.86%),74(21.14%),56(16%)and 34(9.71%),mostly 31 to 40 years.The age of disease ranged from 12 to 69 years with an average age of 39.15±12.67 years,from 12 to 30,31 to 40,51 to 60,61 to 70 years,100(28.57%),108(30.86%),64(18.28%6),51(14.57%)and 27(7.71%),mostly from 12 to 40 years.Of these,180(51.43%)have thyroid nodules,154(44%)have breast hyperplasia,76(21.71%)have breast nodules,and 61(17.43%)have uterine fibroids.There were 103 patients with a family history of thyroid disease,accounting for 29.43%.There were 197(56.29%),89(19.71%),69(24%)at 2 years,2 to 5 years and>5 years respectively.2.Syndrome element distributionSyndrome element distribution in 350 HT patients was 238 liver,234 spleen,34 kidney,25 heart and 10 lung.The distribution rate of spleen increased with age,with statistical differences(P<0.05).Disease course of 2 years,thyroid function is mainly normal;disease course of 2～5 years,thyroid function is mainly normal and hypothyroidism;disease course of>5 years,thyroid function to hypothyroidism.The hypothyroidism distribution rate increased with the disease course,with statistical differences(P<0.05).The distribution rates of spleen,kidney and heart all increased with the disease course,with statistical differences(P<0.05).The common syndrome element of HT include solid and deficiency,qi stagnation(mainly),phlegm dampness,hot and blood stasis were solid,and qi deficiency(mainly),Yin deficiency(mainly),Yang deficiency,blood deficiency were deficiency.Overall,syndrome element is mainly qi deficiency,qi stagnation,Yin deficiency and phlegm dampness.The distribution rate of phlegm dampness,blood stasis,qi deficiency,Yin deficiency and Yang deficiency increased with age,with statistical differences(P<0.05).The distribution rate of qi deficiency and Yang deficiency increased with the disease course,with statistical differences(P<0.05).3.Syndrome distributionIn this study,350 cases of Hashimoto’s thyroiditis included 87 cases of liver depression and spleen deficiency,72 cases of liver stagnation,70 cases of qi and Yin deficiency,62 cases of spleen deficiency and phlegm dampness,30 cases of liver fever exuberant and 29 cases of Yin deficiency and fire flourishing.The trend of each syndrome with age was analyzed,the distribution of liver stagnation decreased with age(P<0.05),and the distribution of qi Yin deficiency increased with age(P<0.05).The trend of each syndrome with the progress of the course of 2 years,mainly liver depression and spleen deficiency,liver stagnation and qi Yin deficiency,the course of 2 to 5 years,liver depression and spleen deficiency,liver stagnation and spleen deficiency,spleen deficiency,qi Yin deficiency and spleen deficiency and dampness syndrome.Analyzing the correlation between syndrome and thyroid function,the results showed that the hepatic fire exuberant syndrome was normal and hyperthyroidism,and the other syndrome was mainly normal and hypothyroidism,with statistical difference(P<0.05).The correlation between syndrome and thyroid volume was analyzed with no statistical difference(P>0.05).Based on frequency statistics,a large proportion of thyroid volume has high syndrome of hepatic fire exuberant and qi Yin deficiency.The correlation between syndrome and thyroid gland flow showed no statistically difference(P>0.05).Based on frequency statistics,those with high blood abundance have hepatic fire exuberant and Yin deficiency and fire flourishing.There was no statistical difference in combining thyroid nodules(P>0.05).CONCLUSION1.Hashimoto’s thyroiditis is mainly female,and the age of onset is mainly young and middle age.Hashimoto’s thyroiditis often combine with thyroid nodules,and female patients often combine with breast hyperplasia,breast nodules and uterine fibroids.Hashimoto’s thyroiditis has a clear tendency for a family history.2.Thyroid function is mainly normal thyroid function and hypothyroidism,and hypothyroidism gradually develops with the course of the disease.3.Syndrome elemrnt include liver,spleen,kidney,heart and lung,mainly liver and spleen.Pathologic syndrome element include qi stagnation,phlegm dampness,blood stasis,hot,Yin deficiency,qi deficiency,Yang deficiency and blood stasis,mainly qi deficiency,qi stagnation,Yin deficiency and phlegm dampness.Spleen became evident with age.Spleen,kidney,heart became evident with the course.Phlegm dampness,blood stasis,qi deficiency,Yin deficiency and Yang deficiency gradually develop with age,and Yang deficiency gradually develop with the course of disease.4.Hashimoto’s thyroiditis syndrome includes liver depression and spleen deficiency,liver stagnation and qi stagnation,qi Yin deficiency,spleen deficiency and phlegm dampnes,liver and fire exuberant,Yin deficiency and fire flourishing.5.All age group has liver depression and spleen deficiency,liver stagnation and qi stagnation gradually obvious with age,qi Yin deficiency gradually decreased with age;there is no statistical difference in syndrome distribution between different disease courses.Based on frequency statistics,the distribution of syndrome showed some trends,but there are no statistical differences;the correlation between syndrome and thyroid function was normal and hyperthyroidism,and other syndrome was mainly normal and hypothyroidism;neither thyroid volume or gland blood flow.There were no statistical differences between syndrome in incorporating thyroid nodules. |
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