The Correlation Between The Distribution Of TCM Syndromes Of Thyroid Nodules And TI-RADS Classification

Objective:Through clinical data of Chinese and western medicine in patients with thyroid nodule investigation,summarizes the thyroid nodules in patients with TCM syndrome type distribution in law.And thyroid nodules of TCM syndrome types were combined with ultrasonic TI-RADS classification to explore the correlation between syndrome type and classification,enrich the theoretical system of TCM syndrome differentiation and treatment,and provide theoretical support for the clinical diagnosis and treatment of thyroid nodule.Methods:A total of 222 patients with thyroid nodules were collected from the department of endocrinology,affiliated hospital of Shandong University of TCM.Record the patient’ s clinical data including thyroid ultrasound,thyroid function,liver function,blood routine,etc.At the same time,through the way of questionnaire to obtain TCM syndromes of the patients,determine the patient’ s pulse condition coating on the tongue,according to the syndrome of pulse and tongue to judge patients of TCM syndrome types includes four syndromes:liver depression with TanNing syndrome,phlegm and blood stasis syndrome,Yin asthenia and internal heat syndrome,spleen and kidney Yang deficiency syndrome.And analyze the distribution of the four kinds of syndrome types in age,sex,smoking history,drinking history,fami ly history.SPSS 22.0 statistical analysis software(Logistic regression,etc.)was used for statistical processing to analyze the correlation between TCM syndrome types and ultrasonic TI-RADS classification.Results:1.The peak of the study’ s overall age distribution was between 56 and 65 years old,and the overall gender distribution was statistically significant(P<0.05),with more female patients than males.2.There were significant statistical differences in the distribution of syndrome types in the four TCM syndromes(P<0.01),among which Yin asthenia and internal heat syndrome was the most distributed(39.6%),and then liver depression with TanNing syndrome(22.5%),kidney Yang deficiency syndrome(22.1%),phlegm and blood stasis syndrome(15.8%)was the least distributed.There was a significant statistical difference in the age distribution of all syndromes(P<0.01).The average age of kidney Yang deficiency syndrome was significantly higher than that of liver depression with TanNing syndrome.There was no statistical significant in syndrome type gender composition ratio among the four groups(P>0.05).3.There were statistical differences in smoking,and family history among the four TCM syndromes(P<0.05).The phlegm and blood stasis syndrome with smoking history was more than liver depression with TanNing syndrome,Yin asthenia and internal heat syndrome,kidney Yang deficiency syndrome(P<0.05),and have a family history of liver depression with TanNing syndrome was more than Yin asthenia and internal heat syndrome(P<0.05).There was no statistical significant in drinking history among the four groups(P>0.05).4.There was no statistically significant difference in the blood routine,thyroid function,liver function,blood lipids and BMI among the four groups of syndrome types(P>0.05).5.There were significant statistical differences in the TI-RADS grading distribution(P<0.01),among which the most distributed TI-RADS were TI-RADS grade 3(70.27%),and then TI-RADS grade 2(13.96%),TI-RADS grade 4a(8.56%),TI-RADS grade 4b and above(7.21%)was the least.There were significant statistical differences in the age distribution of all grades(P<0.01),the age of TI-RADS grade 3 was higher than that of TI-RADS grade 2.There was no statistical significant in the gender composition ratio among the TI-RADS classifications(P>0.05).6.There were statistically significant differences in the TI-RADS classification of smoking history and family history(P<0.05).There were more TI-RADS grade 3 patients with smoking history than TI-RADS grade 2,4a,4b and above patients.For family history,TI-RADS grade 2 was more common than TI-RADS grade 4a.Different grades had no statistically significant difference among drinking history and BMI(P>0.05)7.There was a statistical difference in the TI-RADS grade of thyroid function(P<0.05).The FT4 level of TI-RADS grade 4b and above was higher than that of TI-RADS grade 3.The AST level of TI-RADS grade 4a was higher than that of TI-RADS grade 2.There were no significant differences in the blood routine,ALT and blood lipids of the TI-RADS grades(P>0.05).8.There was a statistical difference between four syndrome types and TI-RADS grades(P<0.05).The TI-RADS grade 2,3 and 4a levels of liver depression with TanNing syndrome were more than phlegm and blood stasis syndrome,Yin asthenia and internal heat syndrome,and the TI-RADS grade 2 and 3 levels of liver depression with TanNing syndrome were more than kidney Yang deficiency syndrome.There were no statistically significant differences in the number,echo,size,boundary,calcification,blood flow and lymph nodes of the four groups(P>0.05).Conclusion:There was a certain correlation between different syndrome types and TI-RADS ultrasonic grading,and the TI-RADS grading of liver depression with TanNing syndrome was lower than others.Yin asthenia and internal heat syndrome was the most distrib uted,an then liver depression with TanNing syndrome,kidney Yang deficiency syndrome,phlegm and blood stasis syndrome was the least distributed.Age,smoking,and family history were the important factors influencing the distribution of TCM syndromes of thyroid nodules.Patients with a history of smoking were more likely to be distributed in the phlegm and blood stasis syndrome,while those with a family history were more likely to be distributed in the liver depression with TanNing syndrome.The most distributed TI-RADS grade was TI-RADS grade 3,and then TI-RADS grade 2,TI-RADS grade 4a,TI-RADS grade 4b and above was the least.And the age of TI-RADS grade 3 was higher than that of TI-RADS grade 2.