| Object:Cases in this study by collecting the clinical data, a retrospective survey of the clincical asthenia syndrome of elder patients with hypothyroidism. Of older age,sex and thyroid hormone levels in thyroid dysfunction due to old age characteristics and laws of syndromes.For elder hypothyroidism exploration and understanding of the unity of a reference.And to better assist the clinical treatment.Methods:Observation of clinical research through the development of form,200 cases were collected. Depending on the different western sub-type (including clinical hypothyroidism and subclinical hypothyroidism) summarized the situation permits, to observe the relationship between TCM syndrome type with age,sex and. thyroid hormone levels.Results:1. The overall distribution of western Sub-Type distribution:clinical hypothyroidism 74 cases, subclinical hypothyroidism 126 cases.2. The distribution of TCM syndrome type with different ages:Subclinical hypothyroidism:The most TCM syndrome happened in the early stage are liver-blood deficiency and deficiency of kidney essence. The most TCM syndrome happened in the later stage are deficiency of kidney-Yang and deficiency of spleen-Qi. Clinical hypothyroidism:The most TCM syndrome happened in the early stage are liver-blood deficiency and deficiency of kidney essence. The most TCM syndrome happened in the later stage are deficiency of kidney-Yang, deficiency of spleen-Qi and Yang and deficiency of heart-kidney Yang.3. The distribution of TCM syndrome type with different thyroid hormone levels:Subclinical hypothyroidism:In TSH group,there are significant differnece between liver-blood deficiency and deficiency of spleen-Qi, deficiency of kidney-Yang. Deficiency of kidney-Yang and deficiency of kidney essence has deficiency of kidney essence too. Clinical hypothyroidism:In FT4 group, there are significant differnece between liver-blood deficiency and deficiency of spleen-Qi and Yang, deficiency of kidney-Yang, deficiency of heart-kidne Yang.Deficiency of kidney essence has the same difference. Deficiency of spleen-Qi and Yang, deficiency of kidney-Yang and deficiency of heart-kidne Yang have the significant difference between each other.In T3 group, deficiency of heart-kidne Yang has the significant difference with other four type of syndrome.Conclusion:1. For elderly patients with primary hypothyroidism, the most common western sub-type are subclinical hypothyroidism, the TCM syndrome goes over from liver-blood deficiency and deficiency of kidney essence to deficiency of spleen-Qi and Yang, deficiency of kidney-Yang, deficiency of heart-kidney Yang(clinical) with the age. The result explains that deficiency of liver and kidney is the primary basic pathology in elderly patients with primary hypothyroidism,and deficiency of heart-kidney-spleen Yang and Qi is the evolutive ending.2. For elderly patients with primary hypothyroidism, the change of the thyroid hormone levels and patient's condition has positive correlation,at the same time,also has the relationship with TCM syndrome,so we can take it as objective evidence of dialectical process of TCM syndrome. Subclinical hypothyroidism has the most relation with TSH, increase with T3, it clue to the pathogenesis of decline of kidney-Yang.In clinical hypothyroidism, although, TSH has the relation with patient's condition,but doesn't have the relation with TCM syndrome.T4 has the biological effect,so it has relation with severity of clinical manifestation.We also find that the decreasing of the FT4 has the relation with the TCM syndrome. With the milestone reduction of FT4, the TCM syndrome goes over from liver-blood deficiency and deficiency of kidney essence to deficiency of spleen-Qi and Yang, deficiency of kidney-Yang, deficiency of heart-kidney Yang(clinical).In the time,we can regard T3 as a sensitive index for decline of kidney-Yang and deficiency of heart-kidne Yang.It also has significance in judging the changes of patient's condition that is turn deficiency to excess or is mixed up with deficiency and excess. |
