TCM Syndrome Differentiation Of Papillary Thyroid Microcarcinoma

Objective: 1.To study the TCM syndrome differentiation of Papillary Thyroid Microcarcinoma(PTMC);2.To explore the correlation between TCM syndrome differentiation of PTMC and clinical objective indicators.Method:117 patients with PTMC who were admitted to the Department of Breast and Thyroid Surgery,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from May 2017 to January 2019 were enrolled.The cross-sectional survey method was used to fill out the TCM Syndromes of Papillary Thyroid Microcarcinoma.Basic data,four diagnostic information,information on color Doppler ultrasound,thyroid function,postoperative pathology,etc.,establish an Excel database,use SPSS 19.0 statistical software to statistically analyze the data,and use exploratory factor analysis to analyze TCM syndrome type.Result:1.The main symptoms of 117 patients with PTMC in this group included 81 cases(69.2%)of neck mass,66 cases(56.4%)of chest pain and abdominal pain,56 cases(47.9%)of emotional depression,and 43 cases of sigh.(36.8%),38 cases(32.5%)had premenstrual breast pain,34 cases(29.1%)had fatigue,31 cases(26.5%)had foreign body sensation in the throat,30 cases(25.6%)had lip gloss,and sublingual varices Thirty patients(25.6%),lazy words in 29 cases(24.8%),27 cases of neck mass pain(23.1%),25 cases of dysmenorrhea(21.4%),24 cases of facial pigmentation(20.5%),48 cases of pulse string(41.0%),31 cases(26.5%)with pulse,22 cases(18.8%)with pulse slip,46 cases(39.3%)with tongue pale,23 cases(19.7%)with tongue purple,44 cases(37.6%)with white fur,moss Greasy in 21 cases(17.9%).2.Exploratory factor analysis of 39 high-frequency symptoms and some low-frequency but more important symptoms showed 7 common factors,namely: factor(1): distress,fatigue,shortness of breath,lazy words,five upsets,Dry mouth,dry throat,red tongue and less,less moss,pulse number,fine pulse;factor(2): physical obesity,neck nausea or obstruction,head and body weight,sticky feeling in the mouth,more under the belt,chest flank Abdominal pain,depression,sigh,foreign body sensation in the throat,pale tongue,white fur,greasy fur,slippery pulse;factor(3): neck mass pain,lip gloss,facial pigmentation,pulse string,dark circles,dysmenorrhea,Sublingual varicose veins,tongue purple,pulse sputum;factor(4): menstrual blood clots,premenstrual breast pain;factor(5): tongue dark purple spots;factor(6): neck mass,bowel stagnation;factor(7):stool Not cool,suffocating.3.According to the above results,the syndrome differentiation of PTMC in this group is divided into three types: 56 cases(48%)with qi stagnation and blood stasis syndrome;43 cases(37%)with liver stagnation and phlegm syndrome;18 cases(15%)with qi and yin deficiency syndrome.4.There was no correlation between the three types of syndromes and echogenic type,microcalcification,nodule morphology,nodule boundary,aspect ratio and blood flow signal of thyroid color Doppler ultrasound(P>0.05);thyroid function FT3,FT4,TSH,Tg,Tg Ab,TPOAb,TRAb The absolute values of the absolute values and the abnormality of index abnormality were not significantly different among the three syndrome types(P>0.05).There was no correlation between the three syndrome types and tumor size,number and lymph node metastasis(P>0.05).Conclusion:1.Qi stagnation and blood stasis syndrome,liver stagnation and phlegm syndrome,qi and yin deficiency syndrome are the three main types of Papillary Thyroid Microcarcinoma.The characteristics of the pathogenesis are based on the virtual standard,and the qi stagnation,blood stasis,and phlegm condensation are the standard.Clinical syndrome is mostly evidenced.2.Ultrasound morphology and Doppler blood flow grading,thyroid function,postoperative pathology and other clinical objective indicators have little significance for Papillary Thyroid Microcarcinoma syndrome differentiation,and further exploration of other dialectical objectification indicators is needed.