The Effect Of Yiqi Yangyin Decoction On Patients With Qi Yin Deficiency Syndrome Postoprative PTC And The Clinical Significance Of The Pretracheal Lymph Nodes In Papillary Thyroid Cancer

Objective1.To study the clinical effect of yiqi yangyin decoction on patients with postoperative qi Yin deficiency syndrome.2.The objective of this study was to determine the incidence and significance of pretracheal lymph node metastasis in papillary thyroid cancer and to evaluate the clinical significance of pretracheal lymph node metastasis in patien ts with papillary thyroid cancer.MethodsI.The research on yiqi yangyin decoction300 cases of thyroid papillary carcinoma postoperative patients-were randomly divided into two groups,Chinese traditional medicine group was given traditional Chinese medicine "yiqi yangyin" soup,control group not be traditional Chinese medicine treatment,medication for 7 days for a period of treatment.Observe the change of the two groups of patients with postoperative symptoms and signs,monitoring before and after treatment of parathyroid hormone,C-reactive protein,blood cortisol,IL-6,fill in the TCM symptom quantization scale respectively.The daily flow rate of drainage tube after operation was calculated,and the time of tube pulling was(the standard of drawing tube was:daily flow rate was less than 10ml).And safety indicators and clinical adverse reactions and side effects..2.The research on pretracheal lymph node metastasisA retrospective study of 245 cases of pre-tracheal lymph node dissection in thyroid papillary carcinoma was conducted.The patients were divided into metastatic and non-metastatic groups according to the postoperative routine pathology.To analyze the correlation between pretracheal lymph node and age,sex,tumor size,multifocal sex,invasion,thyroiditis,location,gene and other regional lymph node metastasis.Results1.It is good to improve the clinical symptoms of patients with postoperative qi Yin deficiency syndrome of thyroid papillary carcinoma,especially tired,sweatiness,insomnia,pharyngalgia and constipation.The decrease of CRP in Chinese medicine group was significantly higher than that in the control group(P<0.05),while there was no significant difference between IL-6 and plasma cortisol(P>0.05).The PTH in the Chinese medicine group were significantly higher than those in the control group(P<0.05).There was no significant difference between the two groups of liquid,and the number of tubule days was significantly less than that in the control group.2.The migration rate of pretracheal lymph nodes in PTC was 35.18%.The difference was statistically significant in the study of pretracheal lymph node metastasis and tumor>lcm,extrathyroid extension,delphian lymph node metastasis,paratracheal lymph node metastasis and lateral neck lymph node metastasis(P<0.05),there was no significant difference with age,sex,multifocality,thyroiditis,location and BRAFV600E mutation(P>0.05).Extrathyroid extension and lateral neck lymph node metastasis were independent risk factors for pretracheal lymph nodes metastasis.In unilateral PTC patients,the metastatic rate of another central lymph nodes was 35.29%when the pretracheal lymph node was positive.The difference was statistically significant of another central lymph node metastasis and tumor ≥1cm,extrathyroid extension,lateral neck lymph node metastasis and the number of lymph node metastasis in the lateral lymph node(P<0.05),there was no significant difference with age,sex,extrathyroid extension,thyroiditis,BRAFV600E mutation and the number of pretracheal and central lymph node metastasis·were independent risk factors for pretracheal lymph nodes metastasis(P>0.05).The lateral cervical lymph node metastasis was an independent risk factors for another central lymph nodes metastasis.·Conclusions1.It is good to improve the clinical symptoms of patients with postoperative qi Yin deficiency syndrome of thyroid papillary carcinoma.There is no obvious damage of liver and kidney function and serious adverse reactions.It is safe and reliable,and deserves further study and promotion.2.PTC patients,in particular,had a tumor≥1cm and extrathyroid extension,which was more likely to occur in the pretracheal metastasis.3.Patients with pretracheal lymph node metastasis are more likely to have metastatic lymph nodes in neck.If there is no evidence of lymph node metastasis in lateral neck before surgery,follow-up should be strengthened.4.In the operation,the unilateral PTC of the preracheal lymph node metastasis and more metastasis of lateral neck lymph node was performed,and another central lymph node dissection was performed.