Study On Application Of Distinguishing Physique-distinguishing Disease-syndrome Differentiation System In Hashimoto’s Thyroiditis And Its Different Disease Stages

Objective:By studying the hashimoto thyroiditis patients and their different clinical stages(stage thyroid function hyperfunction,normal thyroid function,subclinical hypothyroidism period,clinical hypothyroidism)in patients with type of constitution,and to explore its constitution types and the correlation of TCM syndrome types,as well as the related factors influencing the physique,card type,in combination with imaging examination,to establish "Distinguishing Physique-Distinguishing Disease-Syndrome Differentiation " system,for the clinical prevention of hashimoto thyroiditis to provide scientific theory basis.Methods:Patients with Hashimoto’s thyroiditis who met the inclusion criteria and were treated in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2019 to November 2020 were selected to collect and record the basic information of the patients,Doppler color ultrasound data,TCM syndrome,etc.,and the constitutions of the patients were obtained according to the TCM constitution classification judging table.Excel was used to establish the original database,and SPSS24.0was used for statistical analysis to analyze the distribution characteristics of physique and syndrome and their correlation with various factors.Result:1.The prevalence of this disease is significantly higher in women than in men,and the ratio of men towomen is 1:11.8.It is more common in young and middle-aged people,more common in mental workers,and the incidence rate in urban areas is higher than in rural areas.Most patients with Hashimoto’s thyroiditis have nodules.2.The overall distribution of TCM syndromes in patients with Hashimoto’s thyroiditis: spleen and kidney yang deficiency syndrome(39.8%)> liver qi stagnation syndrome(21.1%)> qi and yin deficiency syndrome(16.4%)> liver depression and spleen deficiency syndrome(10.3%)>Heart-Liver Fire Prosperity Syndrome(9.4%)>Blood Stasis and Phlegm Syndrome(3.1%).3.The distribution of the overall physique types of Hashimoto’s thyroiditis patients: Yang-deficiency quality> calm quality>Qi-deficiency quality> Qi stagnation quality> Yin-deficiency quality>Phlegm-dampness quality>Damp-heat quality>blood stasis quality,idiosyncratic quality.The quality of peace is less than the quality of bias.4.There are differences in the distribution of syndrome types in each period(P<0.05).In the hyperthyroidism stage,the heart and liver fire is the main syndrome,the normal thyroid function stage is mainly due to the stagnation of liver-qi syndrome,and the subclinical hypothyroidism stage and hypothyroidism stage are mainly due to the spleen and kidney yang deficiency syndrome.5.There are differences in physique distribution in each period(P<0.05).Yang-deficiency and Qi-stagnation are more common in patients with normal thyroid function,Qi-stagnation and phlegm-dampness are more common in patients with hyperthyroidism,and Yang-deficiency and Qi-deficiency are more common in patients with hypothyroidism and subclinical hypothyroidism.Seen in quality.6.The law of constitution distribution and TCM syndrome types:Qi stagnation is more common in the syndrome of liver depression and qi stagnation;Qi stagnation is more common in the syndrome of liver depression and spleen deficiency;yang deficiency is more common in spleen and kidney deficiency syndrome;qi yin is more common Deficiency of yin in the two-deficiency syndrome is more common;Qi-stagnation is more common in the syndrome of heart and liver fire vigour;7.There is no correlation between age and staging(P>0.05),but it is correlated with TCM syndrome and TCM physique(P<0.05).Syndrome type: Liver Qi stagnation is more common in youth,spleen and kidney Yang deficiency is more common in middle age and old age;Qi deficiency is more common in constitutional youth group,Qi depression is more common in middle-aged group,and elderly group Deficiency of Zhongyang is more common.8.In imaging: nodules are not correlated with the distribution of syndrome types(P>0.05),but are correlated with staging(P<0.05).It is more common in the normal thyroid function stage.The longitudinal diameter of the lateral thyroid lobe and the longitudinal diameter of the isthmus were different(P<0.05).The two longitudinal diameters of patients in the hypothyroidism group were significantly larger than those of the other three groups(P<0.05).The two diameters of patients in the subclinical hypothyroidism stage were larger than those in the hyperthyroidism and normal thyroid stages(P<0.05).The two diameters of patients with normal function were relatively small(P<0.05).Conclusion: 1.The majority of HT patients are female,which is more common in mental workers,and the incidence of HT is higher in urban areas than in rural areas.2.HT patients are often associated with nodules,and nodules are correlated with staging.3.Patients with Hashimoto’s thyroiditis have differences in the distribution of TCM syndromes and constitution,and there are certain rules between the distribution of constitution and syndrome types.4.The TCM syndromes and constitution distribution of patients at different stages are different.5.There is no correlation between age and stage,but certain correlation with syndrome type and constitution;There was no significant correlation between the distribution of nodules and the syndromes.6.Imaging results showed that the longitudinal diameter of the lateral lobe of the thyroid gland was different from that of the isthmus.In the diagnosis and treatment of diseases,the combination of body differentiation,disease differentiation and syndrome differentiation is beneficial to the prevention,diagnosis and treatment of diseases.