Clinical Study On 33 Cases Of Refractory Hyperthyroidism

Hyperthyroidism is a clinical common endocrine disease, the vast majority of patients after treated with anti-thyroid drugs, etc, can achieve symptom relief or clinical cure. But there are a few patients due to the influence of various factors, thyroid stimulating hormone (TSH) constantly stay low or thyroid stimulating hormone receptor antibody (TRAb) stay high, make the illness is not more or recurrent to keep drugs on or reduce odes, the serious influence its work and life or even its birth, we call it refractory hyperthyroidism. Syndrome differentiation of traditional Chinese medicine treatment of refractory hyperthyroidism has obvious advantages, but there is no special clinical reports of traditional Chinese medicine, so it is necessary to study.Objective Through clinical observation, the main symptoms of inductive statistics refractory hyperthyroidism, study its basic pathogenesis, syndrome regularity and to summarize the clinical experience of the tutor Ximing Liu dialectical treatment of refractory hyperthyroidism and drug laws.Method To choose between September 2013 and December 2015, the gate of hospital endocrinology Ximing Liu, a professor at the outpatient service of 33 patients with refractory hyperthyroidism patients treated as the research object, give joint antithyroid drug therapy and traditional Chinese medicine, controlled with themselves before and after, the first treatment was set to 0, in accordance with 0,3,6,9 month period of time to collect data, observed before and after treatment in patients with symptoms, syndrome, TSH values, the change of thyroid function, etc, and statistics and study the correlationship; Using the data mining technology to 33 patients with 297 prescriptions for drugs used frequency, frequency statistics, analyze its characteristics.ResultsGeneral information:Refractory hyperthyroidism patients in the majority with women, men and women ratio of 1:5.5; 75.7% of the patients age< 40 years old; 88% for staff or students; Course of the disease in 2-5 years was 54.5%,9.1% of patients duration> 10 years; 78.8% of the patients with thyroid II degrees or III swelling; 33 cases of refractory hyperthyroidism patients,13 cases of recurrence in patients with hyperthyroidism, not the type of 20 cases of hyperthyroidism patients.Symptoms distribution:13 cases of recurrence of symptoms of hyperthyroidism distribution for palpitation (100%), sweat (76.9%), heat evil (69.2%), irritability (61.5%), tremor (53.8%),20 cases not the distribution of the symptoms of hyperthyroidism is agitated (85.0%), heart palpitations (70.0%), tremor (55.0%), heat evil god (50.0%), fatigue (45.0%), etc. By the Chinese medicine treatment of 3,6,9 months, total effective rate were 94%,97%, 97%, significantly reduced compared with original symptom integral.Syndrome classification:hyperthyroidism relapse type distribution of qi and Yin deficiency (92.35%), heart (stomach) the fire (84.6%), and qi stagnation TanNing (61.5%), blood stasis block (7.7%), etc.; Not the type of hyperthyroidism type distribution of qi and Yin deficiency (95%), heart the fire (70%), and qi stagnation TanNing (65%), blood stasis block (35%), etc. TSH correlation analysis:33 patients with TSH are below normal to begin with, the Chinese medicine treatment, TSH restore normal 21 cases, continued to partial person with 8 cases,4 cases of unstable. Analysis of the correlation is found that the recovery of TSH values and age, course of disease, treatment, FT3, FT4 value to begin with, and degree of goiter are not relevant, but have significant relationship with symptoms improve the situation.Drug laws:this study has counted 297 prescriptions,154 TCM, each formula ingredients between 7-12 flavour, traditional Chinese medicine application frequency> 20% of drug addiction (67.3%), lily (62.6%), and zhejiang fritillary (60.3%), the root of remembranous milk vetch (57.2%), radix scrophulariae (56.6%), cat’s claw (41.1%), Fried radix paeoniae alba (38.4%), dwarf lilyturf (37.0%), soap (34.7%), st John’s wort (27.3%), rhizoma zedoariae (22.9%), cortex moutan (21.5%).Conclusion1. This study observed the main symptoms of refractory hyperthyroidism as palpitation, evil heat, sweat, irritability, etc., high metabolism symptom is not obvious.2. The observation in our study of refractory hyperthyroidism patients have the characteristics of low TSH continued, and found that the recovery of TSH values is closely related to the change of symptom integral, prompt Chinese medicine treatment of refractory hyperthyroidism improveing the symptoms is the key;3. Ximing Liu professor divide the syndrome of refractory hyperthyroidism into four types: deficiency of both qi and yin, hyperactivity of heart-liver fire, stagnant qi and phlegm cohere and blood stasis block. Treatment is given priority to with the drugs of tonifying qi and yin and reducing phlegm and resolving masses.