| Objective:By observing the clinical effect of Huazhuo Jiedu Decoction on subacute thyroiditis and its effect on serum auxin,we enrich the theory and prescription of traditional Chinese medicine for subacute thyroiditis,and further explore the mechanism of Huazhuo Jiedu Decoction in treating subacute thyroiditis.Methods: Sixty patients with subacute thyroiditis who met the Hebei Provincial Hospital of Traditional Chinese Medicine and met the inclusion and exclusion criteria during 2016-2018 were randomly divided into the Chinese medicine treatment group(35 cases)and the western medicine control group(35 cases).Chinese medicine group: patients take Huazhuo Jiedu Granules orally,one dose per day,twice in the morning and evening.If the patient's temperature exceeds 39? for 3 consecutive days or the pain is unbearable,initial treatment with prednisone 10mg/d is given.Western medicine group:patients were given ibuprofen sustained-release capsules 0.3g once or twice a day.If the patient's temperature exceeds 39? for 3 consecutive days or the pain is unbearable,initial treatment with prednisone 10mg/d is given.Both groups took 4 weeks as a course of treatment and observed 2 courses of treatment.The clinical symptoms and signs,laboratory tests,changes of serum auxin,and the addition of prednisone were compared between the two groups after treatment with different drugs.The efficacy of the drug,the incidence of hypothyroidism,the recurrence rate and the drug safety were evaluated.Result:During the study period,2 patients in the Chinese medicine group did not insist on taking the drug off,and 3 patients failed to follow up.Three patients in the western medicine group did not adhere to the drug drop,and 2 patients failed to follow up.The final statistics were 60 patients,30 in the Chinesemedicine group and 30 in the western medicine group.1.Improvement of general clinical symptoms: The time of fever abatement,thyroid pain relief and goiter retraction in the traditional Chinese medicine group were significantly shorter than those in the control group.The difference was statistically significant by t test(P<0.05).Goiter degree: The goiter degree of the Chinese medicine group and the western medicine group after treatment was significantly improved compared with before treatment.Compared with the western medicine group after treatment,the number of cases of improvement in the Chinese medicine group was better than that in the western medicine group,and the difference was statistically significant by rank sum test(P<0.05).2.TCM syndrome points: comparison within the group: The syndrome scores of the Chinese medicine group and the western medicine group at 4weeks and 8 weeks were lower than the pre-treatment scores,and 8 weeks were lower than 4 weeks of syndrome scores,the difference was statistically significant by t test,(P<0.01).Inter-group comparison: The improvement of syndrome score in Chinese medicine group was better than that in western medicine group at 4 and 8 weeks,and the difference was statistically significant by t test(P<0.01).3.Adding prednisone: The total number of patients treated with hormone therapy in Chinese medicine group was 3 cases,and that in western medicine group was 29 cases.The Chinese medicine group was significantly less than the western medicine group.After the chi-square test,the difference was statistically significant(P<0.05).4 Laboratory indicators4.1 Thyroid function: FT3,FT4,ESR in Chinese medicine group and Western medicine group decreased significantly after treatment,TSH increased significantly compared with before treatment,and the difference was statistically significant after t teat(P < 0.05).After treatment,the recovery of thyroid function in Chinese medicine group was better than that in western medicine group,After t test,it had statistical significance(P < 0.05).Thecomparison of the number of normal thyroid function recovery at 2,3,4,6 and8 weeks showed that 24 patients in the Chinese medicine group returned to normal in the 4th week,and 4 patients in the western medicine group returned to normal.After the chi-square test(P<0.01),the difference was statistically significant;at 2,3,6,and 8 weeks,there was no difference by chi-square test(P>0.05).4.2 ESR: After treatment,there was no statistical difference in ESR between the two groups,P>0.05.At 2,3,4,6 and 8 weeks,21 patients in the traditional Chinese medicine group returned to normal ESR and 3 patients in the western medicine group returned to normal ESR.There was a significant difference between the two groups,P<0.01;at 2,3,6 and 8 weeks,there was a significant difference in ESR between the traditional Chinese medicine group and the western medicine group(P<0.01).Chi-square test showed no difference,P>0.05.5.Serum auxin: Before treatment,the level of serum auxin in the two groups was significantly higher than that in the normal control group,and the difference was statistically significant(P < 0.01)by t-test.There was no significant difference between the traditional Chinese medicine group and the western medicine group by t-test(P>0.05).After treatment,the level of serum auxin in Chinese medicine group and Western medicine group decreased significantly compared with that before treatment,and the difference was statistically significant(P<0.01)by t-test;the level of serum auxin in Chinese medicine group decreased more significantly than that in western medicine group,and the difference was significant(P < 0.01),but there was no significant difference between Chinese medicine group and control group(P>0.05);there was still difference between western medicine group and control group(P<0.01).6 Curative effect analysis6.1 Clinical efficacy: The total effective rate of the Chinese medicine group was 96.66%,and that of the western medicine group was 86.66%.There were statistical differences by rank sum test(P<0.05);the curative effect ofChinese medicine syndrome: 96.66% in the Chinese medicine group and83.33% in the western medicine group,and there were statistical differences by rank sum test(P<0.05).6.2 The recurrence rate was 3.33% in traditional Chinese medicine group and 20% in western medicine group.There was statistical difference by Chi-square test,P < 0.05.The incidence of hypothyroidism was 3.33% in traditional Chinese medicine group and 6.66% in western medicine group.There was no significant difference by Chi-square test,P>0.05.7.Safety analysis: The incidence of adverse reactions related to drugs:only one case in the Chinese medicine group had gastric distension and discomfort,and the incidence of adverse reactions was 3.33%.Nine cases in the western medicine group had adverse reactions,including nausea and vomiting in 4 cases,gastrointestinal ulcer in 1 case,rash in 2 cases,headache in 3 cases.The incidence of adverse reactions was 30%.There was statistical difference by Chi-square test(P<0.05).There were no abnormal reactions of blood routine,liver function,renal function,coagulation,electrocardiogram and urinary routine safety indicators in both groups after treatment.Conclusion:1.Huazhuo Jiedu Recipe can significantly improve the clinical symptoms of patients with subacute thyroiditis,improve clinical efficacy,reduce recurrence rate,and have a low incidence of adverse reactions.2.The mechanism of Huazhuo Jiedu Decoction in treating subacute thyroiditis may be related to the influence of serum auxin secretion. |
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