Study On Clinical Features Of Myasthenia Gravis With Thyroid Disease And Distribution Of TCM Syndromes

ObjectiveThis study is to investigate the clinical characteristics of myasthenia gravis patients with thyroid disease and the distribution of TCM syndrome elements,analyze the distribution of TCM syndrome elements in patients with different clinical characteristics,and provide the basis for individualized and objective syndrome differentiation and treatment of the disease.MethodsFrom October 2015 to October 2020,112 patients with myasthenia gravis complicated with thyroid disease in the Department of Spleen and Stomach Disease of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were collected.The data of general information and TCM four diagnostic information were recorded and analyzed.At the same time,the ’ syndrome element identification method ’was used to calculate and determine the location and nature of the patient ’ s syndrome elements,and then SPSS software was used for statistical analysis to explore the distribution of TCM syndrome elements and the correlation between each syndrome element in patients with different clinical characteristics.Results1.Basic information : Among the 112 patients,30 were males(26.79 %),82 were females(73.21 %),and the ratio of males to females was 1 : 2.73,with an average age of(46.13 ± 15.47)years old.The average age of MG was(38.93 ± 17.52)years old.There were 77 cases of early-onset MG(68.75 %)and 35 cases of late-onset MG(31.25 %).The average duration of MG was 7.44 years,and the modified Osserman type IIb accounted for the most(58.04 %).The average age of onset of thyroid disease was(44.21 ± 15.64)years old,and the average duration of disease was 1.54 years.Thyroid nodules accounted for the largest proportion of disease types(52.68 %).Thymectomy was performed in 45 cases(40.18 %),including 15 cases of thymoma,10 cases of thymic hyperplasia,1 case of thymic cyst,and 19 cases of thymic pathological type.There were 12 patients(10.71 %)with MG crisis.2.The main location of MG combined with thyroid disease is spleen,followed by liver,lung,stomach and heart;The main disease is qi deficiency,followed by phlegm,qi stagnation,dampness,blood deficiency,yin deficiency,yang deficiency,heat,drink.3.The distribution of syndrome elements in patients with different gender : The distribution of syndrome elements in patients with different disease location and disease nature between different gender groups was statistically significant(P < 0.05).The proportion of spleen,qi stagnation,dampness and yang deficiency in male group was higher than that in female group.4.The distribution of syndrome elements in patients with different MG courses : there was no statistically significant difference in the distribution of syndrome elements in each disease location and disease nature among different MG courses(P > 0.05).5.The distribution of syndrome elements in patients with different clinical types of MG : there was no statistically significant difference in the distribution of syndrome elements in patients with different clinical types of MG(P > 0.05).6.The distribution of syndrome elements in patients with different thyroid diseases:there was no statistically significant difference in the distribution of syndrome elements in patients with different disease locations and disease types(P > 0.05).7.The distribution of syndrome elements in early-onset and late-onset MG patients:there was no statistically significant difference in the distribution of disease location and disease syndrome elements between early-onset and late-onset MG patients(P > 0.05).8.The distribution of syndrome elements in patients with thymectomy and without thymectomy : The distribution of diseased lung between the two groups was statistically significant(P = < 0.05).The proportion of diseased lung in patients with thymectomy was higher than that in patients without thymectomy.There was no significant difference in the distribution of disease syndrome elements between the two groups(P > 0.05).9.The distribution of syndrome elements in patients with and without onset of crisis :there was no statistically significant difference in the distribution of disease location and disease syndrome elements between the two groups(P > 0.05).10.The syndrome element distribution of patients with different MG treatments : the distribution difference of pathogenic phlegm among different medication groups was statistically significant(P < 0.05),and the proportion of pathogenic phlegm in the single medication group was higher than that in the combined medication group;There was no significant difference in the distribution of syndrome elements in different medication groups(P > 0.05).11.Distribution of syndrome elements in patients taking and not taking drugs for thyroid diseases : There was no significant difference in the distribution of disease location and disease nature between the two groups(P > 0.05).12.Association between syndrome factors of patients : five combinations were obtained after clustering analysis of disease location and syndrome factors of patients,namely,C1 : stomach-blood deficiency-heart-liver,C2 : spleen-qi depression,C3 : yin deficiency-drink,C4 : lung-phlegm,C5 : qi deficiency-yang deficiency.Conclusion1.Patients with MG combined with thyroid diseases are more common in women,and thyroid nodules account for the largest proportion of thyroid diseases.2.The main location of MG combined with thyroid disease is spleen,and the important role of liver cannot be ignored;The main disease is qi deficiency,and the influence of phlegm on the disease should also be paid attention to.3.There are certain differences in the distribution of syndrome elements in MG patients with thyroid diseases with different clinical characteristics,which can provide the basis for the individualized and objective syndrome differentiation and treatment of such patients.