Meta Analysis Of The Treatment Of Hashimoto Thyroiditis From Liver,Spleen And Kidney

Objective: This study intends to make a meta-analysis on the clinical experimental study of treating Hashimoto’s thyroiditis with hypothyroidism from liver,spleen and kidney syndrome differentiation,and explore the clinical efficacy of traditional Chinese medicine in treating Hashimoto’s thyroiditis with hypothyroidism,so as to provide methods and reference for clinical medication and research.Methods: the computer database was used to search the clinical controlled research literature of traditional Chinese medicine in the treatment of Hashimoto’s thyroiditis with hypothyroidism.It includes CNKI,VIP,WF,sinomed and Pub Med.After the duplicate literatures were screened out,the literature was screened according to the exclusion criteria and inclusion criteria,and the data were extracted.The quality of the literatures was evaluated by Cochrane Handbook 5.3,and use Revman 5.3 software perform the meta-analysis.Results: a total of 37 articles were included,including 2745 cases,1375 cases in the experimental group and 1370 cases in the control group.The results of meta-analysis showed that: there was heterogeneity among the studies with outcome indicators of FT3,FT4,TSH,TGAb and TPOAb,and the random effect model was adopted;among the studies with outcome indicators of total effective rate,TCM syndrome score and thyroid volume,the fixed effect model was adopted after excluding some studies by sensitivity analysis.(1)Clinical efficacy: the total effective rate of Hashimoto hypothyroidism Group [RR = 1.35,95% CI(1.29,1.42),P < 0.00001]was higher than that of the control group;(2)FT3: the FT3 value improvement of the experimental group after treatment [SMD = 0.55,95% CI(0.32,0.78),P < 0.00001] was better than that of the control group;(3)FT4: the FT4 value improvement of the experimental group after treatment [SMD = 0.64,95% CI(0.35,0.94),P < 0.00001] was better than that of the control group In the control group.(4)TSH:the improvement of TSH value in the experimental group after treatment [SMD =-0.70,95% CI(-0.91,-0.48),P < 0.00001] was better than that in the control group.(5)TGAb: the TGAb value of the experimental group after treatment [SMD =-1.48,95% CI(-1.85,-1.12),P < 0.00001] was lower than that of the control group.(6)After treatment,the tpoad of the experimental group was lower than that of the control group(-1.000032,-1.000032,-1.000032).(7)TCM syndrome score: the TCM syndrome score of the experimental group after treatment [SMD =-1.37,95% CI(-1.53,-1.21),P < 0.00001]was lower than that of the control group.(8)Thyroid volume: the improvement of thyroid volume in the experimental group after treatment [SMD =-0.77,95% CI(-0.97,-0.57),P < 0.00001] was better than that in the control group.Conclusion: the treatment of Hashimoto’s thyroiditis with hypothyroidism from liver,spleen and kidney has definite curative effect,and the improvement of total effective rate,thyroid function(FT3,FT4,TSH),thyroid antibody(TGAb,TPOAb),TCM syndrome score and thyroid volume in the treatment group is better than that in the simple Western medicine group.Compared with the simple western medicine treatment group,the treatment of Hashimoto’s thyroiditis with hypothyroidism from liver,spleen and kidney has less adverse reactions and good safety.However,the sample size and quality of the literature included in this meta-analysis are small,which may lead to bias risk.In the future,large sample,multi center and high-quality literatures are needed to further confirm.