| Objective:To investigate the incidence and related factors of hyperthyroidism liver damage,and to evaluate the short-term clinical efficacy and safety of Qingjie Ruanjian in the treatment of hyperthyroidism caused by hyperthyroidism liver damage through the comparison of Western medicine and traditional Chinese and western medicine treatment.Methods:(1)A total of 138 outpatients or inpatients who were admitted to the Department of Endocrinology of Jiangsu Provincial Hospital from October 2015 to April 2017 were selected.According to the results of liver function and inclusion and exclusion criteria,the patients were divided into normal liver function groups and liver function impairment.Groups,65 cases and 73 cases,respectively,compared the general conditions,liver function and thyroid function indicators of the two groups,and analyzed the related factors of liver function damage in hyperthyroidism.(2)Selected clinics or inpatients from the Department of Endocrinology of Jiangsu Provincial Hospital from October 2015 to April 2017.All patients were in accordance with the Chinese and Western medical diagnosis and inclusion criteria,and were divided into treatment group and control group according to the random number method,36 cases and 33 cases,respectively,a total of 69 cases,the control group was treated with Western medicine alone,and the treatment group was treated with Western medicine.The patients were treated with Jiejian Ruanfang,and the clinical symptoms,thyroid immunological indicators,liver function,and adverse reactions and drug safety before and after treatment were observed.Results:(1)Correlation analysis:The results of this study show that AST and FT3 are positively correlated with TSH and negatively correlated with TSH in patients with hyperthyroidism.There was a negative correlation between ALT and TSH,P<0.01.There was no significant correlation between y-GT,ALP and TBIL and TSH,FT3,FT4,TRAb,gender,age,and duration of disease.Overall,the severity of liver damage and the patient's gender,age,and TRAb titer were not.Obvious correlation.Therefore,the treatment of hyperthyroidism liver damage,and actively control the primary disease is the key.(2)Clinical curative effect observation:After 3 months of treatment,the curative effect of the two groups both improved.In the treatment group,there were 36 patients,7 cases(19.44%)were markedly effective,28 cases(77.78%)were effective,and 1 case(2.78%)was invalid.The total effective rate is 97.22%.For a total of 33 patients,0(0.00%)was markedly effective,24(72.73%)were effective,9(27.27%)were ineffective,and the total effective rate was 72.73%.The total effective rate of the treatment group was better than that of the control group,with statistical significance(P<0.05).(3)Symptom improvement:Within the group,the goiter in the treatment group was not significantly improved before treatment(P>0.05),but the remaining TCM symptoms were significantly improved before treatment(P<0.01).The symptoms of goiter,palpitations,and mouth dry mouth in the control group were relieved before treatment,but the difference was not statistically significant(P>0.05).The rest of the TCM symptoms improved to varying degrees,with statistical significance(P<0.01).).Among the groups,the symptoms of goiter,heart palpitation,and irritability in the treatment group were improved to varying degrees compared with the control group(P<0.05 or P<0.01),and there was no statistically significant improvement in the other symptoms.(P>0.05).(4)Liver function index:intragroup comparison,0.5 months after treatment,the ALT,AST,ALP,y-GT,and TBIL in the two groups decreased compared with before treatment(P<0.05).Among them,the treatment group ALT,AST,y-GT,The ALT and AST in TBIL and control group were significantly different from those before treatment(P<0.01).Three months after treatment,there were significant differences in ALT,AST,ALP,y-GT,and TBIL between the two groups(P<0.01).The ALT,AST,y-GT,and TBIL in the treatment group decreased significantly 0.5 months after treatment,and the difference was statistically significant(P<0.01).In the control group,y-GT and TBIL decreased compared with 0.5 months after treatment,and the difference was statistically significant.Significance(P<0.05).Between groups,the difference in ALT and TBIL between the treatment group and the control group at 0.5 month after treatment was statistically significant,that is,the ALT decline rate in the control group was better than the treatment group after 0.5 months of treatment,but the control group was in the short term for bilirubin.The improvement was significantly lower than that in the treatment group.Although both AST,ALP,and y-GT were decreased,there was no statistically significant difference(P>0.05).After 3 months of treatment,the ALT,AST,y-GT and TBIL in the treatment group were significantly higher than those in the control group(P<0.01).The above description shows that in the short term,such as the 0.5 months in this study,Western medicine treatment for liver function down the target faster,is better than the combination of traditional Chinese medicine group,but the further course of treatment,stretching the course of treatment,such as 3 months At the time of treatment,the decrease of liver function index in the treatment group was significantly better than that of the control group.That is to say,although the improvement of liver function index in the short-term treatment of Chinese and Western medicine was slightly inferior to that of western medicine alone,the benefit of long course of treatment was obviously better than that of western medicine alone.,And the treatment group liver function returned to normal time is shorter than the control group.Although Western medicine treatment has a tendency to be fierce,it does not have enough stamina,and the combination of traditional Chinese medicine can do more with less.(5)Thyroid Index:? Changes in TSH levels:After 0.5 months of treatment,TSH levels in the treatment group increased slightly,while changes in the TSH level in the control group were not significant.There was no statistical difference between the two groups before and after treatment,but there was a difference between groups.Three months after treatment,the levels of TSH in both groups increased significantly before and 0.5 months after treatment.There was no statistical difference between the two groups.?Changes in FT3 and FT4 levels:After 0.5 months of treatment,the FT3 and FT4 in both groups decreased compared with that before treatment.The difference was statistically significant.There was no statistical difference between the two groups.Three months after treatment,the FT3 and FT4 in both groups decreased compared with that before treatment and 0.5 months after treatment.The difference was statistically significant,and the decrease in FT3 and FT4 in the treatment group was better than that in the control group.There was a statistically significant difference between the two groups.It shows that Qingjie Ruanjian can reduce thyroid hormone levels and has stable curative effect.It can be used synergistically with western medicine.Conclusion:(1)Hyperthyroidism was the most common liver damage in patients with hyperthyroidism.There was a close correlation between liver function and thyroid hormone levels.(2)Western medicine combined Qingjie Ruanjian and Western medicine alone have good curative effect on patients with hyperthyroidism and liver damage,but the combination of Qingjie Ruanjian treatment can make the short-term curative effect more stable,liver function recovery faster,improve thyroid function and TRAb level,lower heart rate,improve the patient's overall symptoms,higher safety. |
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