Study On The Pathogenesis Of Hashimoto's Thyroiditis And Wind Pathogens

OBJECTIVESTUDY1 To explore related drugs and their clinical efficacy in the treatment of Hashimoto’s thyroiditis from the theory of "Congfenglunzhi".STUDY2 To explore the related theories and characteristics of the pathogenesis of"Fengxiezhibing" of Hashimoto’s thyroiditis.STUDY3 To explore the common syndrome types of Hashimoto’s thyroiditis,and to initially explore the distribution of the syndromes and the pathogenic characteristics of"Fengxiezhibing",so as to provide a theoretical basis for the treatment of Hashimoto’s thyroiditis from the wind.METHODSTUDYI(1)A Randomized Controlled Trial Study on the Treatment of HT with Traditional Chinese Medicine are searched through the CNKI,wanfang,VIP and MEDLINE database.The literature was screened according to the inclusion and exclusion criteria,the drugs used were statistically analyzed,and the related drugs with the effect of dispel the wind were summarized.(2)To retrieve published clinical Randomized Controlled Trials literature of wind medicine or prescriptions which contains wind medicine in the treatment of HT.After eliminating the repeating literature,identify the literature which are included in the study according to inclusion and exclusion criteria,and extract data from selected literrature.The quality evaluation of the included literrature was through the Jadad scale and Cochrane handbook 5.0,and data statistical analysis is completed by Review Manager 5.3.STUDY2 Design the interview outline,use the semi-structured interview method to conduct WeChat interviews.Before the interview,explain the purpose of the interview and record the content of the interview.Then organize and archive the content of the interview.Finally,analyze and explore the related theories and characteristics of the pathogenesis of"Fengxiezhibing" of Hashimoto’s thyroiditis.STUDY3 Design questionnaire,clinical collection of HT cases,according to the questionnaire to collect the data of the case,will meet the inclusion criteria were included in the study,sort and enter the clinical data of the selected cases,build a database with Excel 2010.The input data of frequency and cluster analysis through the statistical software of IBM SPSS20.0,then the results are analyzed and discussed.RESULTSTUDY1(1)A total of 78 studies were included,and 22 drugs with dispel the wind effects were used in these studies.There are 11 drugs with function of dispel the wind that can be used in various stages and different types of HT,including Chaihu,Fangfeng,Zhebeimu,Danggui,Chuanxiong,Yinyanghuo,Lianqiao,Banxia,Heshouwu,Chuansha njia,Muli.There are 7 drugs with function of dispel the wind mainly used in patients with normal thyroid function or hyperthyroidism,including Niubangzi,Chuanshanlong,Biejia,Bohe,Qingfengteng,Qianghuo,Jingjie.And Mahuang,Zhifupian,Cangzhu,Bajitian mainly used in patients with hypothyroidism or hypothyroidism.(2)The Meta-analysis results of 8 studies:TSH SMD=-1.75,TGAb SMD=-2.94,TPOAb SMD=-3.68,effective rate OR=3.98,the results are significant in the statistical,the funnel chart of TGAb,TPOAb,and the effective rate basic symmetric,their bias are controllable,TSH exist great bias date.STUDY2 Based on the clinical manifestations of Hashimoto’s thyroiditis and the characteristics of wind pathogens,we believe that wind pathogens are closely related to the occurrence and development of Hashimoto’s thyroiditis.Based on this,we propose the pathogenesis of "Fengxiezhibing" of Hashimoto’s thyroiditis.STUDY3 Among the 87 cases of HT included in this study,76 were female patie-nts and 12 were male patients.Female patients were 6.3 times the number of male pa-tients.Included in the study were 16 patients with inflammatory diseases and 8 patient-s with allergic diseases.The cluster analysis results combined with the clinical experie-nce of my tutor,classified as four types of syndromes:"Yinxuhuowang,Rejishengfeng","Pishenyangxu,Xuexushengfeng","Ganyuqizhi,Yangkangshegnfeng",and "Ganyupixu".CONCLUSIONSTUDY1(1)There are 22 medicines with effect of dispel the wind in the literature researches on the treatment of HT with traditional Chinese medicine.Arnong them,wind medicine is more widely used when thyroid function is normal or accompanied by hyperthyroidism.(2)The dialectical treatment from wind in treating HT has obvious advantages compared with simple LT4 treatment,but since there is little in the number of research literature,methodological quality is low,makes the results have bias of risk.STUDY2 The occurrence and development of Hashimoto’s thyroiditis is closely related to wind.STUDY3 The cluster analysis results combined with the clinical experience of my tutor,can be classified as four types of syndromes:"Yinxuhuowang,Rejishengfeng","Pis-henyangxu,Xuexushengfeng","Ganyuqizhi,Yangkangshegnfeng","Ganyupixu".The occurren-ce and development of HT are closely related to wind pathogens.The early stage is mainly related to external wind and the middle stage is mainly related to internal win-d.In the later stage,the spleen deficiency or the spleen and kidney yang qi are defi-ciency.