Clinical Observation Of Zilong Wenyang Decoction In Treating Elderly Hashimoto’s Thyroiditis With Subclinical Hypothyroidism

Objective: In order to observe the clinical efficacy of Zilong Wenyang decoction in the treatment of senile Hashimoto Thyroiditis with Subclinical Hypothyroidism(renal yang deficiency and obstruction of phlegm-blood stasis type),and to explore new treatment methods and experience for diagnosis and treatment of this disease.Methods: 80 cases was chosen from inpatient and outpatient in Geriatrics and Endocrinology Dept.and accorded with standard of elderly Hashimoto Thyroiditis and Subclinical Hypothyroidism disease(renal yang deficiency and obstruction of phlegm-blood stasis type)from December 2017 to March 2019 in Yunnan Provincial Hospital of Chinese Medicine,and randomly divided into control group and treatment group,40 cases(levothyroxine sodium(Youjiale))of control group and 40 cases(Zilong Wenyang Decoction)of treatment group.The course of treatment are 4 weeks,after that,the data of TCM syndrome,serum thyroid hormone,antibody titer level,blood lipid and body mass index of the two groups were statistically analyzed,and the changes of the data before and after treatment were observed and analyzed.Results: 1.There were 80 cases in the two groups.During the study,5 cases fell off due to disconnection and poor patient compliance,including 2 cases in the treatment group and 3cases in the control group.2.In terms of thyroid function,TSH,TPOAb and TGAb indexes were effectively improved in both groups after treatment(P<0.05).Comparison between the 2 groups,the treatment group were superior to control group in improving TPOAb,TGAb,statistically significant difference(P<0.05).In terms of TSH,comparison between the two groups,there was no statistical significance(P>0.05),shows that the treatment effect of the two groups was equally.And there was no statistical significance(P>0.05)comparison between the two groups or each group in FT3、FT4、TT3、TT4,shows that the items of two groups had no obvious change.3.The blood lipid and body mass index(BMI),the 2 groups can effectively improve the TC,TG,HDL-C,LDL-C and BMI index,statistically significant difference(P<0.05),and the comparison between 2 groups,the treatment group in improving the TC,TG,HDL-C,LDL-C were better than that in control group(P<0.05),the treatment group can obviously improve HDL-C,LDL-C level,with statistically significant difference(P<0.01).In the aspect of BMI,between the 2 groups,there was no statistical significance(P>0.05),this indicated that the two groups had similar therapeutic effects in BMI.4.In terms of TCM syndromes,it showed that both the treatment and control group(except for soft waist and knees and loose stools)could improve TCM syndromes(P<0.05).Comparison between 2 groups,the treatment group in lower TCM syndrome score is better than that in control group(P<0.05),among them,the treatment group can obviously improve the symptoms of soft waist and knees and loose stool,with statistically significant difference(P<0.01).In terms of pre-neck compression symptom,it was no statistical significance(P>0.05)compared between the 2 groups,shows that the two groups had similar therapeutic effects in terms of pre-neck compression.5.In terms of overall efficacy,the total effective rate of the control group was 75.68%,and the total effective rate of the treatment group was 86.84%,with statistical difference between the two groups(P<0.05).6.No obvious adverse reactions occurred in the two groups during the treatment.Conclusion: Zilong Wenyang decoction has good clinical effect in the treatment of senile Hashimoto Thyroiditis with Subclinical Hypothyroidism(renal yang deficiency and obstruction of phlegm-blood stasis type).This prescription can effectively improve TSH,TPOAb,TGAb,TC,TG,HDL-C,LDL-C,BMI indicators of this disease,significantly improve the clinical symptoms,and safe and effective,without obvious adverse reactions,worthy of clinical promotion and application.