Meta Analysis Of Traditional Chinese Medicine Treatment For Hashimoto Thyroiditis Hypothyroidism Stage And Professor Jinzhi Sheng’s Studies On The Law Of Medication

Objective:1.This study used Meta analysis to evaluate the efficacy of traditional Chinese medicine compound in the treatment of hashimoto thyroiditis in hypothyroidism in a comprehensive,systematic and scientific manner,so as to provide evidence-based medical evidence for the clinical application of traditional Chinese medicine.2.Using The Traditional Chinese Medicine Inheritance SupportSystem(TCMISS V2.5)to deeply study professor Jin zhisheng’s prescription for the treatment of hashimoto thyroiditis in hypothyroidism,so as to provide certain reference basis for summarizing and standardizing the clinical treatment of drugs.Method:1.Through a comprehensive retrieve database in both English and Chinese from the building to during January 2020 TCM compound in the treatment of hashimoto thyroiditis JiaJian randomized controlled documents,and according to the set in and exclusion standard screen out the final documents,through Revman 5.3 software Meta analysis and evaluation of literature quality and traditional Chinese medicine compound in the clinical curative effect and the effectiveness of the thyroid function index,etc.2.Collected and sorted out the clinical prescriptions of professor Kim zhisheng’s diagnosis and treatment of hashimoto thyroiditis in the hypothyroidism stage from January2018 to January 2020,and made a visual analysis on the correlation degree of four drugs,four gases and five flavours to the meridian through the Traditional Chinese Medicine Inheritance SupportSystem(TCMISS V2.5),so as to summarize the clinical medication law of hashimoto hypothyroidism stage treated by the tutor.Result:1.Meta-analysis:A total of 2193 articles were retrieved in this study,and 35 articles were finally selected after screening.(1)The total clinical effectiveness results showed RR=1.32,95%CI=[1.26,1.39],P<0.00001,the difference was statistically significant.(2)TSH results showed SMD=-0.57,95%CI=[-0.70,-0.44],P<0.00001,the difference was statistically significant.Subgroup analysis showed pi shen liang xu group(SMD=-0.59,95%CI=[-0.80,-0.38],P<0.00001),pi shen liang xu with tan yu group(SMD=-0.64,95%CI=[-0.89,-0.39],P<0.00001),Other type groups(SMD=-0.57,95%CI=[-0.90,-0.25],P=0.0006),the difference was statistically significant.Gan yu pi xu group(SMD=-0.36,95%CI=[-0.74,-0.01],P=0.06),the difference was not statistically significant.(3)FT3 results showed SMD= 0.86,95%CI=[0.59,1.14],P<0.00001,the difference was statistically significant.Subgroup analysis showed pi shen liang xu group(SMD=0.67,95%CI=[0.28,1.07],P=0.001),pi shen liang xu with tan yu group(SMD=0.82,95%CI=[0.44,1.20],P<0.0001),Gan yu pi xu group(SMD=1.19,95%CI=[0.09,2.30],P=0.03),Other type groups(SMD=1.21,95%CI=[0.25,2.17],P=0.01),the difference was statistically significant.(4)FT4 results showed SMD= 0.91,95%CI=[0.64,1.19],P<0.00001,the difference was statistically significant.Subgroup analysis showed pi shen liang xu group(SMD=0.77,95%CI=[0.30,1.24],P=0.001),pi shen liang xu with tanyugroup(SMD=0.80,95%CI=[0.53,1.07],P<0.00001),Gan yu pi xu group(SMD=1.41,95%CI=[0.26,2.55],P=0.02),Other type groups(SMD=1.02,95%CI=[0.30,1.73],P=0.005)the difference was statistically significant.(5)TPOAb results showed SMD=-1.33,95%CI=[-1.68,-0.99],P<0.00001,the difference was statistically significant.Subgroup analysis showed pi shen liang xu group(SMD=-1.58,95%CI=[-2.24,-0.93],P<0.00001),pi shen liang xu with tan yu group(SMD=-1.46,95%CI=[-1.91,-1.01],P<0.00001),Gan yu pi xu group(SMD=-1.08,95%CI=[-1.94,-0.23],P=0.01),Other type groups(SMD=-0.79,95%CI=[-1.34,-0.24],P=0.005)the difference was statistically significant.(6)TGAb results showed SMD=-1.33,95%CI=[-1.62,-1.04],P<0.00001,the difference was statistically significant.Subgroup analysis showed pi shen liang xu group(SMD=-1.51,95%CI=[-2.08,-0.95],P<0.00001),pi shen liang xu with tan yu group(SMD=-1.30,95%CI=[-1.72,-0.88],P<0.00001),Gan yu pi xu group(SMD=-1.43,95%CI=[-2.11,-0.74],P<0.0001),Other type groups(SMD=-0.63,95%CI=[-0.92,-0.33],P<0.0001)the difference was statistically significant.(7)Security results:there were no adverse reactions and side effects in 26 of the 35 studies.Six studies did not explicitly mention it.Three studies explicitly mentioned safety.There were 6 cases in the control group and 1 patient in the treatment group.2.Analysis of the tutor’s medication rule:a total of 171 prescriptions were collected,including 140 flavors of Chinese medicine,and the total frequency of use was 2386 times.(1)The top ten most frequently used drugs are Astragalus,Epimedium,Poria,Radix Rehmanniae,Chinese yam,angelica,dogwood,Atractylodes,Prunella,and dodder.The top 5drug classification frequencies are tonic medicines(44.38%),the frequency of tonifying drugs was qi-invigorating drugs(40.60%)> yang-yang drugs(31.35%)> blood-enriching drugs(21.44%)> yin-filling drugs(6.61%).(2)The distribution of the five flavors is sweet(1478 times,40.37%),and spicy(1004times,27.43%),The meridian distribution of drugs was mainly liver(1234 times,20.66%),kidney(1139 times,19.07%),and spleen(1130 times,18.92%).(3)The formula analysis found 111 pairs of commonly used drug combinations,26 groups of drug combinations,involving a total of 18 flavors,and common drug combinations were cornel-yam,astragalus-epiporis,epimedium-poria,radix rehmanniae-radix,cornel Mainly yellow-yam and so on.(4)Based on cluster analysis,5 potential core drug combinations and 5 new prescription combinations were obtained.Conclusion:(1)Compared with the control group,the treatment group has advantages in clinical effectiveness,improving TSH,FT3,FT4,and reducing the titers of TPOAb and TGAb;In this study,in terms of TSH,the treatment group of pi shen liang xu or both tan yu stasis is superior to the control group,and the treatment group of liver depression and spleen deficiency is equivalent to the control group;(2)The side effects of the treatment group were less,and the safety assessment was better than the control group;(3)The instructor’s medicinal flavors are mainly warm and calm,sweet and spicy,and the drug classification is mostly tonic deficiency,and the meridian is mostly liver,kidney and spleen meridian,which reflects that the incidence of Hashimoto’s hypothyroidism usually involves liver,kidney and spleen mainly based on warming;(4)The most common drugs are qi-invigorating and yang-invigorating medicines or supplementary medicines for clearing heat,diuresis and dampness,promoting blood circulation and removing blood stasis,resolving phlegm,relieving cough and asthma,and so on.purging fire and nourishing yin,soothing the liver and spleen,regulating qi and resolving phlegm,dispersing blood stasis and dispersing knots.