Clinical Observation Of Modified Fuzi Lizhong Decoction In The Treatment Of Spleen And Kidney Yang Deficiency Primary Hypothyroidism In The Old

Objective: To observe the improvement of clinical symptoms and signs and the change of laboratory indexes in the treatment of senile primary hypothyroidism with spleen-kidney Yang deficiency with fuzi lizhong decoction.Methods: 80 newly diagnosed elderly patients with primary hypothyroidism of spleen-kidney Yang deficiency type were randomly divided into control group and treatment group,40 cases each.The control group was treated with levothyroxine sodium tablets alone,and the treatment group was treated with fuzi lizhong decoction plus decoction on the basis of the control group for 12 weeks.Compare two groups of patients before and after the treatment of TCM syndrome classification of quantitative grading,western medicine dosage,Total cholesterol(TG),Triglycerides(TC),low-density lipoprotein cholesterol(LDL-C),blood calcium,Blood phosphorus,?-C-terminal telopeptide of type I collagen(?-CTX),Propeptide of type I procollagen(PINP),lumbar spine bone mineral density T value level 2-section 4 before and treatment,treatment of 4 weeks,8 weeks,12 weeks of Free Triiodothyronine(FT3),Free thyroxine(FT4),Thyroid stimulating hormone(TSH),and other indicators of change,to evaluate the clinical curative effect.Results:1.Clinical comprehensive efficacy: the total effective rate of the controlgroup and the treatment group was 80% and 90%,respectively,and the total effective rate of the treatment group was better than that of the control group(P < 0.05).2.Efficacy of TCM symptoms: the effective rates of the control group and the treatment group were 87.5% and 95% respectively,and the efficacy of TCM symptoms in the treatment group was better than that in the control group(P<0.05).3.After treatment,the TCM syndrome scores of the two groups decreased compared with that before treatment(P<0.05),and the treatment group was superior to the control group(P<0.05).4.After 12 weeks of treatment,the single symptom of the two groups was lower than that before treatment except forgancy and indifference(P<0.05).The symptoms of edema,mental fatigue,waist and knee tenderness,chills and aversion to wind,tepid limbs,abdominal distension and fatigue,and constipation were better in the treatment group than in the control group(P<0.05),and no difference was found in the comparison between the other groups(P>0.05).5.FT3,FT4 and TSH in the two groups were significantly improved after treatment compared with before treatment(P<0.05).After 4 weeks and 8weeks of treatment,FT3,FT4 and TSH in the treatment group were significantly improved compared with the control group(P<0.05).After 12 weeks of treatment,there was no significant difference in FT3,FT4 and TSH between the two groups(P>0.05).6.Comparison between groups after treatment(P<0.05)showed that the dosage of levothyroxine sodium tablets in the treatment group was less than that in the control group during the whole course of treatment.7.The levels of TC,TG and LDL-C in both groups decreasedsignificantly compared with those before treatment(P < 0.05).After treatment,the improvement of TC,TG and LDL-C was better than that of the control group(P < 0.05).8.After treatment,PINP and ?-CTX in the two groups were improved compared with those before treatment(P<0.05).After treatment,the improvement of PINP in the treatment group was better than that in the control group(P<0.05).After treatment,?-CTX was no statistical difference between the two groups(P>0.05).9.Calcium and phosphorus in the treatment group were significantly increased after treatment compared with before treatment(P < 0.05).After treatment,the difference was statistically significant(P < 0.05).10.The t-value of bone mineral density in the treatment group was improved compared with that before treatment(P < 0.05).The improvement of T value in the treatment group was better than that in the control group(P<0.05).11.The adverse reaction rates of the control group and the treatment group were 7.5% and 15% respectively,and the adverse reaction rates of the treatment group were less than those of the control group(P<0.05).Conclusion:Fuzi lizhong decoction with levothyroxine sodium tablets can better relieve patients' clinical syndromes,reduce patients' pain,quickly restore the level of thyroid function,regulate lipid metabolism,improve bone metabolism,improve bone density,can reduce the dosage of western medicine in elderly patients with hypothyroidism,and less adverse reactions.