Study On The Association Rules Between TCM Symptoms Of Hashimoto's Thyroiditis With Thyroid Function And Autoantibodies

Objective The purpose of this study is to construct a core data set of Hashimoto's thyroiditis clinical research in Chinese medicine.By collecting real clinical diagnosis and treatment data and applying machine learning algorithms,the core symptoms of Hashimoto's thyroiditis patients can be mined to establish Hashimoto's.The association rules between TCM symptoms,thyroid function and autoantibodies in patients with thyroiditis,with a view to providing "objective" auxiliary decision-making basis for TCM clinical syndrome differentiation and therapeutic effect evaluation.Methods Under the guidance of the "COMET Handbook" published by the international COMET DATABASE and combining the characteristics of traditional Chinese medicine theory,a core data set for clinical research of Hashimoto's thyroiditis in Chinese medicine was constructed.Based on the core data set,a questionnaire was designed to investigate Hashimoto's thyroiditis patients treated by a thyroid disease specialist at a third-class Chinese medicine hospital in Hubei Province.Cases were screened based on the inclusion and exclusion criteria.The included patients were clustered based on TCM symptoms.Based on this,a second-order confirmatory factor analysis model between TCM symptom groups,thyroid function indexes and autoantibody indexes based on real clinical diagnosis and treatment data was constructed.Results This study is based on 228 Hashimoto's thyroiditis clinical trials of Chinese medicine,comprehensively collecting the symptom indicators of clinical outcome reports,forming an original list of core data sets containing 161 symptoms,referring to "Traditional Chinese Medicine Terms","Differential Diagnosis of TCM symptoms"(Second Edition),"Research on TCM symptomatology " merges and normalizes the symptoms in the original list,and uses the standardized symptom indicators as alternatives to develop a Delphi expert consultation form.After two rounds of Delphi surveys,15 experts were invited to participate in the consensus meeting.The 29 symptom reached consensus constituted the core data set of Hashimoto's thyroiditis TCM symptoms.A total of 149 patients with Hashimoto's thyroiditis were included in the cross-sectional study.The analysis of the basic characteristics of the patients showed that the male to female ratio was 1: 6.1,the peak age of the disease was 18 to 45 years,and the average age was 39.6 ± 12.7 years.Emotional analysis of patients showed that the scores of psychological resilience of female patients were lower than those of male patients,and the difference was statistically significant(P <0.05).Patient symptom analysis showed that gender and thyroid function will not affect the distribution of high-frequency symptoms,and age has a significant(P <0.05)effect on the occurrence of symptoms such as irritability,fatigue,and anger.Perform cluster analysis on the patients and classify them into three categories: the first category: the core symptoms are anger,fear of heat and sweating,elimination of hunger,blurred vision,dry mouth,swollen eyelids,palpitations,and hand tremor.The second category: core symptoms are irritability,dreaminess,swollen front neck,light mouth,chest tightness,and difficulty swallowing.The third category: core symptoms are fatigue,drowsiness,insomnia,photophobia,hair loss,dry stools,tearing,and chills and cold limbs.The analysis of laboratory indicators showed that the difference in serum TSH levels between male and female patients was statistically significant(P <0.05).The distribution of serum TGAb in patients with normal thyroid function,hyperthyroidism,and hypothyroidism was not significant,but the distribution of serum TPOAb was significant.Difference(P <0.05).During the confirmatory factor analysis,the initial model had CFI = 0.837,TLI = 0.801,AGFI = 0.846,with a general adaptability,and further adjusted the model.The revised structural equation model CMIN / DF = 1.135 <2,CFI = 0.969,TLI = 0.962,GFI = 0.952,AGFI = 0.935 are all greater than 0.9,SRMR = 0.078 <0.08,RMSEA = 0.03 <0.05,the model fits well.At this time,the model shows that the laboratory indicators are significant for the Yin deficiency and fire vigorous syndrome(P <0.05)Positive effects,including FT4 and TAGb,have strong correlations with heart palpitations,palpitations,hunger,chest tightness,drowsiness,fatigue,and dreaminess,which may be the risk factors for these symptoms.Conclusion 1.There are significant differences in the distribution of serum TPOAb in patients with different thyroid functions.The thyroid function of female patients is more vulnerable than that of men.2.Cluster analysis divided Hashimoto's thyroiditis patients into 3 categories,indicating that the progression of Hashimoto's thyroiditis is divided into different periods.3.The laboratory indicators FT4 and TAGb are strongly correlated with heart palpitations,eliminating valley hunger,chest tightness,drowsiness,fatigue,and dreaminess.