Scale-based Research On Traditional Chinese Medicine Syndrome Elements Of AIT In Normal Thyroid Function

Purpose:Establish Autoimmune thyroiditis(AIT)TCM syndrome elements diagnostic scale adopting procedures and current recognized scale development to standardize AIT TCM syndrome standards.Investigate symptom distribution of TCM syndromes and correlation between the syndrome elements and clinical indicators based of the developed scale,to provide an objective basis for clinical diagnosis and treatment.Material and method:Part 1: This part is about the development of the AIT TCM Syndrome Element Diagnostic Scale.Determine TCM four diagnostic information and syndrome elements of AIT using literature investigation?clinical investigation and expert consultation.Collected 242 cases of AIT patients' four diagnostic information by means of multi-center clinical epidemiological investigation,bolted syndrome elements items with correlation analysis?stepwise regression and factor analysis means,assigned four diagnostic information items with logistic regression analysis,determined syndrome elements diagnostic threshold with ROC curve,and established AIT TCM Syndrome Elements Diagnostic Scale.Then texted the clinical authentication reliability?validity of scale using 100 patients extracting by random number table.Part 2: This part is the preliminary application research of the scale.Differentiation of TCM symptoms and signs of 242 cases of AIT patients using developed scale which get through analyze demographic data,personal history characteristics,TCM syndrome element distribution and syndrome clustering.On the basis of the symptoms distribution,normalize treatment group of 242 cases AIT patients' clinical conventional indicators,investigate the relevance between symptoms and clinical indicators,and to explore the relationship with AIT syndrome element factors.Results: 1 Scale research results(1)The AIT TCM Syndrome Element Diagnostic Scale includes 8 syndrome elements.The final four diagnosis items,scores,and diagnostic thresholds show that: Qi deficiency: mental fatigue and feeble(4 score),shortness of breath(2 score),reluctant to talk(3 score),spontaneous sweating(3 score),hyperhidrosis(1 score),palpitations(4 score),narrow pulse(3 score),diagnostic threshold is 9 score;Yin deficiency: five upset dryness-heat(13 score),insomnia(2 score),dreams(1 score),thirsty(1 score),mouth dry(2 score),diagnostic threshold is 8 score;Yang deficiency: chilly(3 score),mental fatigue and feeble(1 score),pale complexion(7 score),frequency and much urine(4 score),light tongue(4 score),diagnostic threshold is 8 score;Spleen deficiency: poor appetite and appetite(4 score),abdominal distension(4 score),reluctant to talk(1 score),fat tongue(1 score),diagnostic threshold is 4 score;Liver depression: impatience and irritability(3 score),sigh(4 score),worry and depression(3 score),bitter mouth(3 score),fullness of the chest and thigh(1 score),red tongue(2 score),pulse string(3 score),diagnostic threshold is 11 score;Kidney deficiency: waist and knee weakness(1 score),swelling of lower extremities(4 score),frequent and much nocturnal urine(4 score),early morning diarrhea(3 score),low menstrual flow(3 score),pale tongue(2 score),weak pulse(3 score),diagnostic threshold is 5 score;Phlegm turbidity: mouth sticky(4 score),pharyngeal discomfort(6 score),sleepiness(3 score),forgetfulness(3 score),abdominal distension(4 score),diagnostic threshold is 11 score;Blood stasis: skin nails wrong(3 score),dark menstruation(1 score,astringent pulse(5 score),diagnostic threshold is 3 points.(2)The split-half reliability of the scale is 0.674,the Cronbach's ? coefficient is 0.639,extracts 3 common divisors for factors analysis that cumulative variance contribution is 56.545%,the coefficient correlation is 0.259?0.671(P <0.01).2 The preliminary application research of the scale(1)Qi deficiency is the main syndrome of AIT,followed by Liver depression,Blood stasis,Spleen deficiency and Yang deficiency,with the least Phlegm turbidity.The cluster analysis of syndrome elements can be divided into 4 categories: the first category includes Spleen deficiency and Phlegm turbidity;the second category includes Yang deficiency and Kidney deficiency;the third category includes Qi deficiency,Liver depression and Yin deficiency;the fourth category is Blood stasis.(2)The statistical analysis of thyroid function showed that the levels of FT₄ in the Qi deficiency and Spleen deficiency groups were lower than those in the non-Qi deficiency and non-Spleen deficiency groups(P<0.05).In terms of thyroid autoantibodies,the levels of Tg Ab and TPOAb in patients with Spleen deficiency were significantly higher than those in non-Spleen deficiency groups(P<0.05).Conclusion: 1.This study established the diagnostic criteria of 8 TCM syndrome elements in AIT.2.The main syndromes of AIT are Qi deficiency,Liver depression,Blood stasis,Spleen deficiency,and Yang deficiency.And Spleen deficiency is the premise and foundation of AIT.