Investigation Of TCM Constitution And Analysis Of Related Risk Factors In Patients With Hashimoto's Thyroiditis And Nodule

Purpose:This study is to observe the relationship between Hashimoto’s thyroiditis of normal thytiod function and Thyroid nodule with Chinese medicine physique.By analyzing the potential factors and exploring the susceptible constitution of the combination of the two diseases,we can provide theoretical reference for guiding the clinic,expanding the ideas of diagnosis and treatment and adjusting the Chinese medicine physique.Material and method:1.A total of 352 Hashimoto’s thyroiditis patients with normal thyroid function who receive treatment in endocrinology clinic of Liaoning University of Traditional Chinese Medicine from June 2020 to December 2021 were selected.Among them,203 cases of patients with Thyroid nodule(TI-RADS 3)indicated by color doppler ultrasound were selected.The age of these patients ranged from 18 to 75 years,and the course of disease ranged from 1 to 10 years.2.Assisting patients conduct Chinese medicine physique surveys according to the physical fitness criteria in ‘Classification and Determination of Chinese medicine physique’.At the same time,the data of patients were collected,including name,gender,height,weight,BMI,occupation,education level,emotional status,habit of eating seafood,smoking history,drinking history,sleep status,family history,five items of thyroid function,blood lipid level and thyroid color doppler ultrasound.3.Input the datum into Excel 2019 and use SPSS23.0 statistical software for statistical and analysis.Results:1.In this study,the incidence ratio of male and female patients was 1:5.3.Patients aged 40 ～59 years were more common(30.5%).Gender differences don’t affect the age of predisposition.The BMI of most patients was in the normal range(50.2%).The majority of occupations are mental workers(59.6%).The patients with frequent thinking(26.6%),anger(24.6%)and sadness(18.7%)were more.In addition,The proportion of patients without smoking and drinking history,occasional consumption of seafood,poor sleep and no family history accounted is relatively large.2.In this study,the main Chinese medicine physique distribution law of patients is: qi deficiency constitution(25.6%)>qi stagnation constitution(23.6%)>phlegm-dampness constitution(12.8%)>yang-deficiency constitution(10.8%)>balanced constitution(9.9%)>yin-deficiency constitution(7.9%)>dampness-heat constitution(5.9%)>blood stasis constitution(3.4%).3.There were 15 cases of simple Chinese medicine physique(7%)and 188 cases of compound Chinese medicine physique(93%).In the distribution of main Chinese medicine physique and the first compound Chinese medicine physique,yang-deficiency constitution combining with qi deficiency constitution(27 cases),phlegm-dampness constitution combining with qi stagna tion constitution(24 cases)and qi stagnation constitution combining with qi deficiency constitution(22 cases)are more common.4.Qi deficiency constitution and qi stagnation constitution are common in female patients.Qi deficiency constitution and qi stagnation constitution are common in patients aged 40 to 49 years.Qi deficiency constitution and qi stagnation constitution are common in normal BMI group.Qi deficiency constitution and qi stagnation constitution are common in mental work people.Phlegm-dampness constitutionand dampness-heat constitution are common in patients with smoking and drinking history.Phlegm-dampness constitution and dampness-heat constitution are common in patients with sad.Qi deficiency constitution and qi stagnation constitution are common in patients with anger mood.Qi deficiency constitution and qi Stagnation constitution are common in patients with poor sleep.5.TPOAb and TGAb levels are significant differences in qi deficiency constitution and yang-deficiency constitution(P<0.05),and severe abnormalities were more severe than mild abnormalities.The levels of TC,LDL-C and HDL-C are the highest in dampness-heat constitu-tion,and exceed the normal reference range.Conclusion:1.The traditional Chinese medicine constitution of hashimoto’s disease with normal thyroid function of nodules is mainly biased.Qi deficiency constitution,qi stagnation constitution and phlegm-dampness constitution may increase the risk of disease.2.Patients with compound constitutions have higher risk of disease with compound constitutions of yang-deficiency constitution combining with qi deficiency constitution,phlegm-dampness constitution combining with qi stagnation constitution,qi stagnation constitution combining with qi deficiency constitution,qi stagnation constitution with blood stasis constitution.3.Women aged 40～59 with qi deficiency constitution and qi stagnation constitution,mental workers with qi deficiency constitution,smoking and drinking people with phlegm-dampness constitution and dampness-heat constitution,sad perpons with qi deficiency constitution and phlegm-dampness constitution,angry perpons with qi deficiency constitution and qi stagnation constitution,poor sleep perpons with qi deficiency constitution and qi stagnation constitution suggest a risk of Hashimoto’s disease with nodules.It can provide reference for guiding patients to adjust their lifestyle and prevent the disease4.The levels of TPOAb and TGAb in patients with qi deficiency constitution and yangdeficiency constitution may be seriously abnormal.The levels of TC,LDL-C and HDL-C were higher in patients withdampness-heat constitution.In the treatment,attention should be paid to the changes of antibody level and blood lipid level,and appropriate use of drugs for supplementing Qi and Yang and clearing heat and reducing humidity.