Clinical Observation On Short-Term And Long-Term Effect Of Graves Disease Treated By Integrated TCM And Western Medicine

Objective:1. To evaluate clinical short-term effect of integrated TCM and western medicine on treatment of Graves disease pertaining to combined blood stasis and phlegm fire syndrome.2.To evaluate the long-term effect of GD treated by integrated TCM and western medicineMethod:1. By use of queue, parallel, controlled clinical study,120 cases of patients with GD within 2 years were divided into treatment group and control group. With 3 month as a time point,2 groups were observed for two points. Short-term observation items include clinical signs and symptoms, thyroid function thyroid antibodies and thyroid volume changes.2.60 cases of patients over 2 years were observed, with 30 cases in each group.Long-term effect items include the recurrence rate recurrence interval, degree of severity of relapse, recurrence complications, minimum maintenance dose of medicine, Results:1. Short-term effects: (1) disease effect:the total effective rate was 93.44%in the treatment group, with 85%in the control group,with no significant difference between the two groups (P> 0.05).(2) syndromes effect:the total effective rate was 96.25%in the treatment group, with 80.00%in the control group, but the signs and symptoms in patients treated with traditional Chinese medicine and western medicine got improved better than the control group, with significant difference. (P <0.05).(3) thyroid function:FT3 after three and six months were significantly reduced in the treatment group (P<0.01); FT3 after 6 months was significantly decreased in control group (P<0.01).After 6 months,treatment group is superior in the FT3 reduction than the control group, with significant difference (P<0.05); FT4 were both significantly reduced in the two groups (P <0.05 or P<0.01), no significant difference between the two groups were observed (P> 0.05); TSH in both groups increased significantly (P<0.01),but no significant difference between the two groups were observed (P> 0.05).(4) thyroid-associated antibodies:TGAb and TMAb were decreased in both groups,and TMAb in treatment group got decreased more obviously,with significant difference P<0.05)(5) thyroid volume:volume reduction of thyroid in the treatment group was obvious than the control group. (P<005).2. Long-term effect(1) In 60 patients whose course of disease over 2 years,31 patients got relapsed,11 cases are in the treatment group, the relapse rate is 36.67%; 20 cases are in the control group, the relapse rate is 36.67%. Recurrence rate between the two groups were significantly different(p<0.05).(2) The severity of recurrence:the severity of recurrence between the two group were significantly different(p<0.05)Prompt that in the recurrence, the control group is more serious than treatment group.(3) Recurrence interval:in 31 cases of recurrence, the shortest recurrence interval of the treatment group is 2 months, the longest is 15 years, in the control group the shortest is 1 month, the longest is 23 years. The average time of recurrence interval is (4.13±4.64 yearVS2.61±5.05 year) Recurrence interval between the 2 groups is significantly different(p<0.0l) (4) Complications relapse:when relapse, the proportion of Liver damage, neutropenia, rash or itching In the treatment group is lower than control group. the results were significantly different (P<0.01)Conclusion:(1) Qinggan Jieyu prescription combine with ATD can significantly improve the clinical symptoms and signs of high metabolic of Pyrophlegm Stagnation GD patients decline Thyroid hormone levels improve thyroid-associated antibodies level, reduced thyroid volume. (2) Compare to the treatment of western medcine alone, Integrative Medicine can efficiently decline the GD Recurrence rate prolong the Recurrence interval time, improve the pathogenetic in recurrence, prevent complications relapses.