Study On The Distribution Of TCM Syndromes Of Hyperuricemia And Its Associated Thyroid Dysfunction

ObjectiveBy obserbving and collecting clinical data,this study statistically analyzed factors of hyperuricemia and thyroid dysfunction,and explored the intrinsic correlation of these two diseases and the distribution of traditional Chinese medicine(TCM)syndromes.The study aims to provide certain guidance to future clinical and scientific research,and give fuller play to the advantages of TCM syndrome differentiation and therapy.MethodsIn this study,patients with hyperuricemia who stayed in the department of nephrology and endocrinology of Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine from September 2015 to September 2017 were selected as the study objects and filled in patient observation forms.The contents of the observation included:basic conditions,clinical laboratory indicators,TCM syndrome score scale.According to the patient's laboratory index and diagnostic criteria for thyroid dysfunction,the included hyperuricemia cases were divided into two groups,normal thyroid function group and abnormal thyroid function group.The two groups were compared in terms of age,gender,BMI,laboratory indicators,comorbidities and TCM syndromes;the abnormal thyroid function group was further subdivided into six groups:hyperthyroidism group,subclinical hypothyroidism group,hypothyroidism group,subclinical hypothyroidism group,low T3 syndrome group and positive thyroid autoantibodies group.Six groups were compared for age,gender,BMI,laboratory indicators,comorbidities and TCM syndromes.Furthermore,SPSS 20 statistical software was used to analysis the data and conclusions are drawn.Research resultsAmong 180 cases of hyperuricemia included in this study,84 cases had thyroid dysfunction and the prevalence was 46.7%.Among them,the proportion of low T3 syndrome was the highest 30.56%,following by positive thyroid autoantibodies which accounted for 11.67%.In the comparison of the related factors of the normal thyroid function group and the abnormal group:male:female ? 5.6:1 in normal group,2:1 in abnormal group,1:2.25 in hypothyroidism group and 5:2 in low T3 syndrome group and 1:1 in positive thyroid autoantibodies group.In terms of age distribution,the abnormal group accounted for 40-60 and 60-80 years old.The prevalence of the hyperthyroidism group was concentrated in middle-aged and young people(20-40 and 40-60 years old);the prevalence of subclinical hyperthyroidism and hypothyroidism was concentrated in middle-aged and elderly people(40-80 years old);low T3 syndrome and the positive autoantibodies group was distributed in each age group,with the largest proportion in 40-80 years old.In the comparison of height,weight and BMI,the difference between the normal group and the abnormal group was statistically significant.But there was no statistical difference when BMI was divided into 3 levels.In the comparison of laboratory indicators,the mean values of TG and GLU in the two groups were higher than the normal range,while the BUN in the abnormal group was higher than that in the normal group.The hyperthyroidism,hypothyroidism,low T3 syndrome and positive autoantibodies group were statistically significant in the TC comparison.In the comparison of comorbidities,the proportion of hyperthyroidism that combined with hypertension,diabetes,hyperlipidemia,fatty liver,atherosclerosis,coronary heart disease,cerebrovascular disease and chronic kidney disease was higher than that of the normal group.When comparing the two groups with hypertension and diabetes,the difference was statistically significant.On the distribution of TCM syndromes,hyperuricemia cases presented a mixture of deficiency syndromes and excess syndromes.Deficiency syndromes mainly included qi deficiency,spleen deficiency,and yin deficiency.The excess syndromes were mostly damp heat,phlegm dampness and blood stasis.The proportion of spleen deficiency in the normal group was higher than that of the abnormal group,while the proportion of qi deficiency,phlegm dampness,and yang deficiency in the normal group were lower than that in the abnormal group;There was no significant difference between the groups of damp heat,yin deficiency,kidney deficiency,liver depression,blood stasis,andblood deficiency syndromes.According to the subdivision of the abnormal group,the results were as follows:The hyperthyroidism group was with the greatest proportions of excess sydromes such as dampness heat and liver depression,while the deficiency syndrome was more common with yin deficiency.The hypothyroidism group with the greatest proportions of deficiency syndrome,and sequentially were qi deficiency,yin deficiency and yang deficiency;Phlegm and dampness is the most common excess syndrome.In positive autoantibodies group,qi deficiency and yin deficiency were the most common deficiency syndromes,while phlegm dampness and liver stagnation were the most common excess sydromes.In low T3 syndrome,qi deficiency and yin deficiency were also the most common deficiency syndromes while dampness heat,phlegm dampness and blood stasis were the most common excess sydromes.Research Conclusion(1)Hyperuricemia is associated with thyroid dysfunction.In this study,thyroid dysfunction mainly demonstrated as mildly decreased T3 and positive TPOAb and TGAb.Other thyroid dysfunction disorders were rare.(2)The TCM syndromes in hyperuricemia are manifested as mixture of deficiency syndromes and excess syndromes.The deficiencies are mainly qi deficiency,spleen deficiency and yin deficiency;the excesses are mainly damp heat,phlegm dampness and blood stasis.Pathogenesis are spleen deficiency and dampness heat.(3)Hyperuricemia with thyroid dysfunction demonstrated as aggravation of qi deficiency,yang deficiency and phlegm dampness.