Clinical Observation On The Treatment Of Hashimoto's Thyroiditis With Internal And External Application Of Chinese Medicine Combined With Local Injection Of Thyroid

ObjectiveThree methods of combined treatment of Hashimoto's thyroiditis with deficiency of Qi and Yin by internal and external application of traditional Chinese medicine combined with local injection of glucocorticoid into thyroid gland.By observing the changes in the disease efficacy,clinical syndrome efficacy of TCM,thyroid function,thyroid autoantibodies and thyroid size of the patients after treatment,to explore the feasibility and mechanism of the combi-nation of these three methods for the treatment of Hashimoto's with deficiency of Qi and Yin.Give full play to the advantages of inte-grated TCM and western medicine in the treatment of this disease,to provide new ideas for clinical treatment of Hashimoto's thyroiditis,and provide better service for the patients.MethodsA total of sixty-four patients were selected for the diagnostic criteria of Hashimoto's thyroiditis with deficiency of Qi and Yin.All cases were from January 2016 to December 2017 in the department of endocrinology in Guanggu hospital district of Hubei Provincial Hospital of TCM,who accept internal and external application of TCM combined with local injection of glucocorticoid into thyroid gland.And continued to consolidate treatment for two months after discharge.Then go back to the department of thyroidopathy or endoc-rine department in Hubei Provincial Hospital of TCM.All the pa-tients were treated with internal and external application of TCM combined with local injection of glucocorticoid into thyroid gland.To observe the changes after the treatment in the disease efficacy,clinical syndrome efficacy of TCM,the degree of goiter,thyroid textures,serum free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),thyroid size and thyroid blood flow signal from thyroid color Doppler ultrasound.And the corre-sponding statistical methods are used to analyze the relevant data.Results1.In this clinical study,sixty-four patients were included.After treatment,the total effective rate was 79.69%.The results showed that the combined effect of the three methods on hashimoto thyroiditis was obvious.2.The study showed that the total effective rate of TCM symptom observation was 85.94%,indicated that the combination of the three methods can obviously improve the clinical syndromes of TCM.In addition,the main symptoms and secondary symptoms of the patients after treatment were significantly improved.And the comparison of the data before and after treatment was statistically significant(P<0.05).3.After the treatment,the degree of thyroid enlargement and thyroid texture of the patient were significantly improved compared with those before treatment(P<0.05).4.The thyroid function(serum FT3,FT4,TSH)and thyroid autoantibody level of the patients after treatment fluctuated somewhat compared with that before treatment,but the difference was not statistically significant(P>0.05).5.After treatment,color Doppler ultrasound showed that the sizes of left and right diameter,anteroposterior diameter of left and right thyroid leaves and isthmus all significantly reduced(P<0.01),and the thyroid blood flow signal was also improved before treatment(P<0.05).6.Safety evaluation:the patient did not experience any discom-fort during the treatment,and there were no obvious changes in blood analysis,liver function,kidney function and other aspects after the treatment(P>0.05).ConclusionThis clinical study showed that the three methods of combined treatment of Hashimoto's thyroiditis with deficiency of Qi and Yin by internal and external application of TCM combined with local injection of glucocorticoid into thyroid gland curative effect significantly.It can obviously improve the clinical symptoms,not only reducing the level of goiter,improved thyroid texture,im-proved the thyroid size and blood flow prompted by thyroid colour Doppler ultrasound,and the treatment process was safe,no adverse reactions,which highlight the special advantage of combined TCM and Western medicine in the treatment of this disease,it is worthy to spread in clinical practice.