Distribution And Correlation Of TCM Syndrome Types In Patients With Papillary Thyroid Carcinoma

Objective: To explore the correlation between TCM syndrome types and clinical data in patients with papillary thyroid carcinoma,including TCM symptom information,thyroid function,ultrasonography,pathological features,etc.,and to compare the distribution rules between different syndrome types.By combining the results of TCM syndrome differentiation and modern diagnostic techniques,it provides an objective reference index for TCM symptom diagnosis and a basis for integrated TCM and Western medicine diagnosis and treatment of papillary thyroid cancer.Methods: This study collected inpatients from December 2020 to December 2021 in the Department of Thyroid and Breast Surgery,Hubei Provincial Hospital of Traditional Chinese Medicine,Guang gu District,and enrolled 161 people who met the criteria.The basic information of the patients,TCM symptoms,thyroid function,thyroid ultrasound characteristics,and pathological reports were collected.Univariate analysis was used first to obtain the variables with statistical differences among the syndrome types,and then binary logistic regression analysis was used to obtain the independent factors of each syndrome type.Results1.A total of 161 patients were collected in this study,of which37 were male,accounting for 23.0% of the total;124 were female,accounting for 77.0% of the total.There were 36 people in the liver stagnation and qi stagnation group,accounting for 22.36% of the total number;42 people in the phlegm-dampness coagulation group,accounting for 26.09% of the total number;58 people in the phlegm and blood stasis syndrome group,accounting for 36.02% of the total number;25 people in the yin deficiency and internal heat group people,accounting for 15.53% of the total number.2.There was no significant difference in gender,age and BMI among different TCM syndrome types in patients with papillary thyroid carcinoma（P>0.05）.3.There was no significant difference in the three items of thyroid function and whether combined with HT among patients with different TCM syndromes of papillary thyroid carcinoma（P>0.05）.4.There was no significant difference in nodule composition and echo quality among different TCM syndrome types in patients with papillary thyroid carcinoma（P>0.05）,but there were statistical differences in tumor shape,aspect ratio,calcification,internal echo,boundary and blood supply（P<0.05）.5.There were no significant differences in lymph node metastasis,recurrence risk,and TNM staging among patients with papillary thyroid carcinoma with different TCM syndrome types（P>0.05）,but there were significant differences in the largest tumor diameter,number,and capsule invasion（P<0.05）.6.The results of binary logistic regression analysisLiver-qi stagnation syndrome was related to the maximum Results:diameter（P=0.005）,aspect ratio（P=0.022）,morphology（P< 0.001）,quantity（P=0.001）,internal echo（P=0.049）and boundary（P=0.002）of the tumor.The risk factors of liver-qi stagnation syndrome were uneven echo,which had statistical significance（OR=7.09,P=0.049）.The protective factors of liver-qi stagnation syndrome were maximum d i a m e t e r ≥ 1 c m（O R = 0.1 1 4,P = 0.0 0 5）,aspect ratio≥1（OR=0.117,P=0.022）,irregular shape（OR=0.019,P<0.001）,multiple tumor foci（OR=0.078,P=0.001）and unclear boundary（OR=0.128,P=0.002）,which were statistically significant.Phlegm-dampness coagulation syndrome was related to aspect ratio（P<0.001）,morphology（P=0.001）,number of tumors（P<0.001）and membranous invasion（P=0.005）.The risk factors of phlegm-dampness coagulation syndrome included irregular shape（OR=8.176,P=0.001）and multiple tumor foci（OR=15.116,P<0.001）,which were statistically significant.The protective factors of phlegm-dampness coagulation syndrome we reaspect ratio≥1（OR=0.005,P<0.001）and membranous invasion（OR=0.167,P=0.005）,which were statistically significant.Phlegm and blood stasis syndrome was related to the maximum diameter of tumor（P=0.002）,aspect ratio（P<0.001）,calcification（P=0.004）,number of tumor（P=0.034）,and boundary（P=0.002）.The risk factors of phlegm-stasis syndrome were maximum diameter≥1cm（OR=44.83,P=0.002）,aspect ratio≥1（OR=225.799,P<0.001）,calcification（OR=22.544,P=0.004）and unclear boundary（OR=65.588,P=0.002）,which had statistical significance.The protective factor of phlegm-stasis syndrome was multifocal tumor（OR=0.149,P=0.034）,which was statistically significant.Yin deficiency and internal heat syndrome was related to aspect ratio of tumor（P=0.04）,calcification（P<0.001）,morphology（P=0.03）,internal echo（P=0.035）and membrane invasion（P=0.004）.The risk factors of Yin deficiency internal heat syndrome were aspect ratio ≥1（OR=3.61,P=0.04）,irregular shape（OR=3.429,P=0.03）and membranous invasion（OR=6.017,P=0.004）,which had statistical significance.The protective factors of Yin deficiency internal heat syndrome were calcification（OR=0.018,P<0.001）and uneven echo（OR=0.173,P =0.035）,which were statistically significant.Conclusion: There was a correlation between liver-qi stagnation,phlegm-dampness coagulation,Phlegm and blood stasis syndrome,Yin deficiency and internal heat with tumor morphology,aspect ratio,presence or absence of calcification,maximum diameter,internal echo,boundary,maximum diameter,number and membranous invasion.The risk factors of liver-qi stagnation syndrome include uneven echo inside tumor.The risk factors of phlegm-dampness coagulation syndrome include irregular tumor morphology and multifocal tumor.The risk factors of Phlegm and blood stasis syndrome include maximum diameter≥1cm,aspect ratio≥1,calcification and unclear boundary.The risk factors of Yin deficiency and internal heat syndrome include tumor aspect ratio≥1,irregular morphology and membranous invasion.