| ObjectiveTo analyse disease outcomes and summarize the prognoses and outcomes characteristics of subacute thyroiditis(SAT)treated by TCM treatment by observing the long-term efficacy of 60 cases of SAT.Method1.Collected 60 SAT patients who met the inclusion criteria and whose first visit time was range from December 2015 to December 2017.Using self-control method,real-time records of patients'condition changes at the first,third,sixth,twelfth and twenty-four months after their first visit were recorded.The last record time was Dec.31,2018,and the longest course was counted for those less than 24 months.2.Follow-up information came from patients'subsequent visit data,telephone follow-ups and electronic questionnaire information collections;follow-up content included medical history,treatment process,symptoms and signs,thyroid function,auxiliary examination results,recurrences,etc.and the SAT case follow-up form s were filled in.3.The table data were entered into Excel 2007 to establish a database,and were analyzed by SPSS22.0.Result1.General data:There were 353 visits in 60 SAT patients,including 9 males(15.00%)and 51 females(85.00%).The ratio of males to females was 1:5.7.The oldest was 63 years old and the youngest was 26 years old,with an average age of 43.47±9.49.2.Clinical characteristics:43 cases(71.67%)were initially diagnosed as active stage,5 cases(8.33%)in remission stage and 12 cases(20.00%)in convalescence stage,27 cases(45.00%)were manifested as thyroid pain and fever,21 cases(35.00%)were only thyroid pain,and 12 cases(20.00%)were disappeared from thyroid pain and fever.3.Course characteristics:The longest course of 60 patients with SAT was 45 months and the shortest was 37 days.The course of disease was less than 3 months in 14 cases(23.33%),from 3 to 6months in 19 cases(31.67%),from 6 to 9 months in 7 cases(11.67%),from 9 to 12 months in 7 cases(11.67%),from 12 to 18 months in 6 cases(10.00%),from 18 to 24 months in 1 case(1.67%)and from 24 months in 6 cases(10.00%).4.Long-term efficacy:(1)Symptom distribution:Before treatment,symptoms of 60 SAT patients:thyroid pain in 48 cases(80.00%),fever in 27 cases(45.00%),fatigue in 23 cases(38.33%),sweating in 22 cases(36.67%),irritability in 21 cases(35.00%),etc.Symptoms after treatment:11 cases(18.33%)were irritable,10 cases(16.67%)were fatigue,10 cases(16.67%)were constipation,9 cases(15.00%)were insomnia,6 cases(10.00%)were weight loss,etc.(2)Evolution of syndromes:Syndromes of 60 SAT patients before treatment:40 cases(66.67%)of pathogen stagnation of Shaoyang syndrome,9 cases(15.00%)of qi-yin deficiency syndrome,6 cases(10.00%)of wind-heat invasion syndrome,and 5 cases(8.33%)of liver-qi stagnation syndrome.After treatment,there were 46 cases(76.67%)of excess evil consumption of yin syndrome,and 14 cases(23.33%)of deficiency of yang-qi syndrome.(3)The condition of thyroid function:Thyroid function of 60 SAT patients before treatment:22 cases(36.67%)with normal thyroid function,32 cases(53.33%)with hyperthyroidism,4 cases(6.67%)with subclinical hypothyroidism and 2 cases(3.33%)with hypothyroidism.After treatment,53 cases(88.33%)had normal thyroid function,2 cases(3.33%)had subclinical hypothyroidism and 5 cases(8.33%)had permanent hypothyroidism.Among 60 SAT patients,16(26.67%)always had normal thyroid function,3(5.00%)always had hypothyroidism,2(3.33%)always had subclinical hypothyroidism,14(23,33%)had changed from transient Hyperthyroidism to Hypothyroidism and normal thyroid function,6(10.00%)had changed from transient hyperthyroidism to subclinical hypothyroidism and normal thyroid function,12(20.00%)had changed from transient hyperthyroidism to normal thyroid function,and 5(8.33%)had changed from subclinical hypothyroidism or hypothyroidism to normal thyroid function,2 cases(3.33%)had changed from transient hyperthyroidism to hypothyroidism.(4)Recurrence:1 of 60 SAT patients(1.67%)relapsed after treatment with traditional Chinese medicine,once at a year after the first visit.5.SAT prognoses:(1)The incidence of transient hyperthyroidism was 56.67%.The occurrence time of transient hyperthyroidism was within 50 days,lasting for 34-68 days,and incidence of transient hyperthyroidism was slight.(2)The incidence of subclinical hypothyroidism was 18.33%.The occurrence time of subclinical hypothyroidism was 50-150 days,lasting for 34-150 days,72.73%of which showed mild subclinical hypothyroidism.(3)The incidence of hypothyroidism was 35.00%.The incidence of permanent hypothyroidism was 8.33%.The occurrence time of hypothyroidism was 50-100 days,lasting for 60-180 days3and permanent hypothyroidism lasted for life.Conclusion1.The incidence of SAT is mainly female,and most of them are young and middle-aged.Most of the clinical manifestations of SAT were thyroid pain and fever,or only thyroid pain.2.The disease outcomes of SAT:88.33%of patients with normal thyroid function,3.33%of patients with subclinical hypothyroidism and 8.33%of patients with permanent hypothyroidism.3.Prognoses of SAT treated by TCM:the incidence of transient hyperthyroidism is 56.67%;the incidence of subclinical hypothyroidism is 18.33%;the incidence of hypothyroidism is 35.00%,the incidence of permanent hypothyroidism is 8.33%.4.The recurrence rate of SAT treated by TCM:1 of 60 SAT patients relapsed after TCM treatment,the recurrence rate was 1.67%. |
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