Clinical Study Of Herb-partitioned Moxibustion On The Navel For Hashimoto's Thyroiditis

OBJECTIVE:1.Based on current clinical evidence,explore the feasibility of using moxibustion to treat Hashimoto's thyroiditis;2.Observe the effects of herb-partitioned moxibustion on the navel on clinical symptoms score,thyroid function,morphology and health status of Hashimoto's thyroiditis patients.METHOD:1.Meta-analysis:Search the CNKI Database,Chinese Biomedical Literature,Wan Fang Database,Pubmed,Embase and Cochrane Library by computer to retrieve all randomized controlled clinical trials of moxibustion for Hashimoto's thyroiditis.Clinical evidence of moxibustion treatment for Hashimoto's thyroiditis was collected by manual screening.The risk of bias assessment tool recommended by Cochrane Handbook was used to evaluate the quality of the included trials,and the software Review Manager 5.3 was used for statistical analysis and mapping2.Clinical research:Sixty patients were divided into the herb-partitioned moxibustion on the navel group and the flour-partitioned moxibustion on the navel group(each group of 30 people)by randomized single-blind method.After three courses of treatment,changes in the clinical symptoms,thyroid hormones levels(FT3,FT4,TSH),thyroid antibody titer(TPOAb,TGAb),health questionnaire score(SF-36).thyroid size of the two groups were observed before and after treatmentRESULTS:1.Meta-analysis results:(1)Compared with western medicine alone,the effect of moxibustion on increasing FT3 value is better than that of western medicine;In terms of reducing the TGAb value,MCA value,and TSH value of patients with Hashimoto's thyroiditis,the effect is equivalent to that of western medicine and tends to be better than that of western medicine.The effect of increasing FT4 value of Hashimoto's thyroiditis patients is equivalent to that of western medicine(2)Compared with western medicine alone,moxibustion combined with western medicine has better efficacy than western medicine in reducing TGAb value,MCA value and TPOAb value of Hashimoto's thyroiditis patients,better efficacy than western medicine in increasing FT3 value of Hashimoto's thyroiditis patients,and better effect than western medicine in improving clinical efficacy;In terms of reducing the TSH value of patients with Hashimoto's thyroiditis,the effect is equivalent to that of western medicine and has a tendency to be better than that of western medicine.In terms of increasing the FT4 value of patients with Hashimoto's thyroiditis,the effect is equivalent to and has a tendency to be superior to western medicine2.Clinical research results:(1)Improvement of clinical symptoms of traditional Chinese medicine:The clinical symptoms of swelling in the neck,chills and colds,epigastric or flank pain,emotional depression,and uncomfortable stool in patients in the herb-partitioned moxibustion on the navel group were significantly improved(P<0.01),The clinical symptoms of emotional depression and uncomfortable stool in patients in the flour-partitioned moxibustion on the navel group improved significantly(P<0.01);The total effective rate of herb-partitioned moxibustion on the navel group was 80.95%,and the total effective rate of flour-partitioned moxibustion on the navel group was 42.11%.There was a significant statistical difference between the two groups(P<0.01)(2)Improvement of thyroid hormone levels:The level of FT3,FT4,and TSH of the herb-partitioned moxibustion on the navel group after treatment were significantly different from those before treatment(P<0.01);Only FT3 level was statistically significant in the flour-partitioned moxibustion on the navel group(P<0.01)after treatment;There was a statistically significant difference between the two groups in the improvement of thyroid hormone levels(P<0.05)(3)Improvement of thyroid antibody titer:The TPOAb?TGAb of the herb-partitioned moxibustion on the navel group after treatment were significantly different from those before treatment(P<0.01);The TPOAb?TGAb of the flour-partitioned moxibustion on the navel group after treatment were significantly different from those before treatment(0.01<P<0.05).There was no statistically significant difference between the two groups in the improvement of thyroid antibody titer(P>0.05).(4)Improvement of thyroid size:There were significant statistical differences between the Maximum diameter of thyroid nodule,thickness of the isthmus,left lobe and right lobe before and after treatment in the herb-partitioned moxibustion on the navel group(P<0.01);There was no statistical difference before and after treatment in the flour-partitioned moxibustion on the navel group(P>0.05).There was a statistical difference between the two groups(P<0.05).(5)Improvement of SF-36 score:General health,bodily pain,role-physical,social function and role-emotional were improved after treatment in the herb-partitioned moxibustion on the navel group(P<0.05);Only general health was improved after treatment in the flour-partitioned moxibustion on the navel group.CONCLUSION:1.Current clinical evidence shows that moxibustion may have advantages in treating Hashimoto's thyroiditis compared with conventional western medicine.2.Herb-partitioned moxibustion on the navel can significantly improve the traditional Chinese medicine clinical symptoms,the thyroid hormone levels(FT3,FT4,TSH)and thyroid antibody titer levels(TPOAb,TGAb)of Hashimoto's thyroiditis patients,and improve patients'quality of life,partly improve the degree of goiter.The effect of herb-partitioned moxibustion on the navel is better than the flour-partitioned moxibustion on the navel.