Analysis Of TCM Syndrome Differentiation And Treatment Rules In Patients With Graves Disease

Objective:Through analysis of diagnostic and treatment data and literature data mining,this study aims to investigate the characteristics of traditional Chinese medicine(TCM)syndromes and medication patterns of Graves’ disease,exploring its four diagnostic characteristics,commonly used formulas,TCM syndrome types,and medication patterns.Based on the above research,summarize the TCM syndrome and treatment patterns of Graves’ disease,and provide reference for clinical treatment.method:1.Collect diagnosis and treatment data of Graves’ disease patients from Professor Du Likun from April 2021 to October 2022.A total of 191 patients who met the inclusion and exclusion criteria were collected.A database was established based on the patient’s diagnosis and treatment data,and SPSS 25.0 software was used to analyze traditional Chinese medicine syndromes and explore prescription medication patterns.The characteristics of traditional Chinese medicine syndromes and medication patterns of Graves’disease were summarized.2.Collect 37 clinical research articles on the treatment of Graves’ disease with traditional Chinese medicine,select their traditional Chinese medicine syndrome Types,Prescriptions and traditional Chinese medicine prescriptions to establish a database,and use data mining methods such as frequency and clustering to summarize their medication patterns.result:1.Research on Diagnosis and Treatment Data of Graves’ Disease PatientsGeneral situation:The majority of patients are women,and the proportion of women in most age groups is higher than that of men.The shortest duration of patients is one month,and the longest duration is six years.The highest proportion of patients with a duration of less than 18 months(39.79%),7.85%of patients have a family history of thyroid disease,10.47%of patients have a history of smoking,29.84%of patients have experienced negative life events,most patients have a second degree of goiter(51.31%),and 71.73%of patients have decreased TSH,The proportion of patients with elevated TRAb was 94.76%,the proportion of patients with elevated TPOAb was 65.45%,the proportion of patients with elevated TGAb was 41.88%,and the proportion of patients with vitamin D deficiency was 80.65%.Traditional Chinese Medicine Four Diagnosis:Inspection Diagnosis of TCM are anterior cervical enlargement(56.54%),reddish complexion(36.1 3%),exophthalmos(3 1.94%),followed by yellowish complexion(2 8.2 7%),with other manifestations accounting for less than 20%.The main manifestations of tongue diagnosis are red tongue,thin tongue,thin coating,and yellow coating,all accounting for over 30%;The symptoms of auscultation are lack of breath,strong voice,and excessive breathing,accounting for more than 20%of the cases;The main manifestations of inquiry are palpitations,fever,insomnia,spontaneous sweating,irritability,and irritability,accounting for more than 3 0%;The pulse pattern is mostly fine rapid stringlike pulse and string pulse,all accounting for more than 20%.Traditional Chinese Medicine Syndrome Type:The most common syndrome type is Yin deficiency and Yang hyperactivity syndrome(38.74%),followed by liver stagnation and qi stagnation syndrome(18.32%)and liver fire hyperactivity syndrome(16.23%).The proportion of phlegm and blood stasis syndrome and heart liver yin deficiency syndrome is less than 10%.Prescriptions:There are 21 commonly used prescriptions,which are classified into 9 categories.Among them,heat clearing agent,conciliating agent,tonic agent,and wind regulating agent are widely used.The top 6 high-frequency prescriptions were Ejiao Jizihuang Tang,Yiguan Jian,Fumai Tang,Shengmai San,Yunv Jian,and Danzhi Xiaoyao San.Traditional Chinese Medicine:There are 46 commonly used traditional Chinese medicines,which are classified into 12 categories.Among them,heat clearing drugs are most frequently used(578 times),followed by deficiency tonifying drugs(305 times).The most common one among the four traditional Chinese medicines is cold,accounting for 43.48%,followed by warm and calm,both accounting for over 20%;The common five flavors are bitter,sweet,and spicy,accounting for 47.83%,45.65%,and 23.91%respectively;The most common meridian is the liver meridian,accounting for 52.17%,foll owed by the lung meridian,spleen meridian,heart meridian,and kidney meridian,all accounting for over 3 0%;The top 10 high-frequency Chinese medicines are rehmannia glutinosa,ophiopogon j aponicus,liquorice,white peony,tuckahoe,angelica,ass hide glue,yam,prunella vulgaris,oyster.2.Literature Study on the Treatment of Graves’ Disease with Traditional Chinese MedicineTraditional Chinese Medicine Syndrome Type:The most common syndrome type is Heart Liver Fire Hyperactivity Syndrome(31.34%),foll owed by Yin Deficiency Yang Hyperactivity Syndrome(11.43%)and Liver Fire Hyperactivity Syndrome(11.43%),with other syndrome types accounting for less than 10%.Category of traditional Chinese medicine prescriptions:There are three categories of prescriptions.Self prepared and experienced prescriptions account for the highest proportion(81.08%),foll owed by ancient proven prescriptions(16.22%),and traditional Chinese patent medicines and simple preparations accounts for the lowest proportion(2.70%).Category of Traditional Chinese Medicine:A total of 56 traditional Chinese medicines are classified into 10 categories.Among them,heat clearing drugs are most frequently used(with a frequency of 122 times),followed by deficiency tonifying drugs(with a frequency of 87 times).The top 10 high-frequency traditional Chinese medicines are Prunella vulgaris,Fritillaria thunbergii,Radix Bupleuri,Radix Paeoniae Alba,Ophiopogonis,Gardenia jasminoides,Scutellaria baicalensis,Radix Scrophulariae,Cortex Moutan,and Oy ster.Traditional Chinese Medicine’s Four Qi,Five Flavors,and Meridians:Cold is the most common(4 8.21%)in the Four Qi of Traditional Chinese Medicine,followed by Wen(2 5.0 0%)and Ping(14.29%).The five flavors are Bitter(50%),Gan(46.43%),and Xin(30.36%),respectively.Salt and acid account for less than 10%,and the most common Meridians are the Liver Meridian(46.43%).Cluster analysis of traditional Chinese medicine to obtain three groups of traditional Chinese medicine.The first group consists of Schisandra chinensis,Forsythia suspensa,Pinellia ternata,Coptis chinensi s,Xiangfu,Sour jujube kernel,Poria cocos,Angelica sinensis,Atractylodes macrocephala,and Astragalus membranaceus.The second group consists of oysters,peony bark,raw rehmannia root,licorice root,Scutellaria baicalensi s,Xuanshen,Gardenia jasminoides,Ophiopogon japonicus,white peony,and Bupleurum chinense.Conclusion:1.Research on Diagnosis and Treatment Data of Graves’ Disease PatientsThe patient population is mainly composed of middle-aged and young women.The pulse pattern is mostly fine rapid stringlike pulse and string pulse,while the tongue pattern is mostly red tongue,thin tongue,thin fur,and yellow fur.The main types of traditional Chinese medicine syndromes are yin deficiency and yang hyperactivity,liver depression and qi stagnation,liver fire hyperactivity,and qi yin deficiency.Yin deficiency and yang hyperactivity are the most common syndromes.The commonly used formulas are Ejiao Jizihuang Tang,Yiguan Jian,Fumai Tang,Shengmai San,Yunv Jian,and Danzhi Xiaoyao San.The most commonly used tonifying drugs are followed by heat clearing drugs,with the most common properties being moderate cold,foll owed by warmth and calmness,the most common taste being bitter,foll owed by sweetness and spiciness,and the most commonly used traditional Chinese medicine for regulating the liver meridian.The top 10 high-frequency Chinese medicines are rehmannia glutinosa,ophiopogon j aponicus,liquorice,white peony,tuckahoe,angelica,ass hide glue,yam,prunella vulgaris and oyster.2.Literature Study on the Treatment of Graves’ Disease with Traditional Chinese MedicineThe common traditional Chinese medicine syndrome types of this disease are heart liver fire hyperactivity syndrome,yin deficiency yang hyperactivity syndrome,and liver fire hyperactivity syndrome.The commonly used formulas are mainly empirical formulas and self formulated formulas.Heat clearing drugs are the most frequent,followed by tonifying drugs;Cold is the most common in medicinal properties,followed by warm and calm;Bitterness is the most common in the medicinal taste,foll owed by sweetness and bitterness;There are the most traditional Chinese medicines for regulating the liver meridian.The top 10 high-frequency traditional Chinese medicines are Prunella vulgaris,Fritillaria thunbergii,Bupleurum chinense,Paeonia lacti flora,Ophiopogon j aponi cus,Gardenia jasminoides,Scutellaria baicalensis,Scrophulariae,Peony skin,and Oyster.Three combinations were obtained from the clustering of traditional Chinese medicine.The first combination was suitable for qi deficiency syndrome,the second combination was suitable for heart and liver fire hyperactivity syndrome,yin deficiency and yang hyperactivity syndrome,and liver fire hyperactivity syndrome,and the third combination was suitable for patients with obvious goiter.