Analysis Of Liver Injury In Graves’ Disease Treated With Traditional Chinese Medicine And Its Relationship With TRAb

Objective:To explore the common Herbs,prescription rules and characteristics of the treatment in liver injury associated with Graves’ Disease(GD),the correlative indicators and Medication law were analyzed and summarized from published literatures.And clinical research were conducted to investigate the correlation between thyroid stimulating hormone receptor antibody(TRAb)and liver function index in GD.Methods:Literatures about integrating traditional Chinese and western medicine for the treatment of hyperthyroidism,or GD,with liver injury were retrieved in cnki,wanfang and weipujian database for nearly 40 years.Literatures that met or did not meet the inclusion criteria were strictly screened.The collected literatures were statistically analyzed and relevant laws of traditional Chinese medicine(TCM)for the treatment of GD combined with liver injury were summarized.In the empirical research,newly diagnosed 231 cases with GD were collected,among them,178 of which are female patients,the rest 53 are male patients.To detect all patients TRAb,thyroid function and liver function index,We use Statistical methods,such as chi-square test,nonparametric test,inspection,Logistic regression analysis and ROC curve analysis to explore the correlation between abnormal liver function index and TRAb in GD..Results:(1)21 literatures were included,among which 5 literatures were Chinese patent medicine for hyperthyroidism or GD,combined with abnormal liver function,and the rest were self-made prescription for hyperthyroidism or GD,combined with abnormal liver function.For the treatment of hyperthyroidism or GD,combined with abnormal liver function with TCM,the mechanisms of TCM include inhibiting thyroid hormone,regulating autoimmunity and anti-inflammatory and antioxidant effects.(2)Totally,21 prescriptions,73 traditional herbs and 805 pairs of traditional Chinese medicines were collected for the treatment of hyperthyroidism combined with abnormal liver function.The categories of TCM include antipyretic drugs,fuzhengbuxu drugs,drugs for regulating qi and reducing phlegm,drugs to promote blood circulation and remove blood stasis and so on.Among them,prunella vulgaris was the most frequently used herb,and prunella vulgaris combined with paeonia alba was the most commonly used drug pair.(3)In newly diagnosed GD patients,their liver function was affected by TRAb.VWhen TRAb was greater than 11.96IU/L,serum alkaline phosphatase(ALP)increased significantly with the increase of TRAb titer,while other liver function indicators did not show direct correlation with TRAb level,after controlling the age,sex,thyroid hormone level and other liver function indicators.Conclusion:(1)The treatment of GD with abnormal liver function by traditional Chinese medicine mainly improves liver function by inhibiting thyroid hornmone,regulating autoimmunity and anti-inflammatory and antioxidant,and alleviates the symptoms of hyperthyroidism.(2)Traditional Chinese medicine for GD complicated with liver dysfunction is treated from the liver,heart,spleen and kidney;The drugs most commonly used are heat-clearing drugs,accompanied by products f-or regulating qi and resolving phlegm,promoting blood circulation and resolving blood stasis.Last but not least,patients with yin deficiency or even qi and Yin deficiency plus products for nourishing qi and Yin.(3)TRAb affects the liver function indexes of Graves’ disease patients,which may be an independent factor affecting the elevation of ALP.