Meta-analysis Of Traditional Chinese Medicine Combined With LT₄ In The Intervention Of Hypothyroidism With Dyslipidemia

Purpose:The Meta method was used to analyze the efficacy evaluation of traditional Chinese medicine combined with L-T₄compared with L-T₄alone in improving patients'symptoms,TC,TG and thyroid function level,and to provide evidence-based medical evidence for the treatment of hypothyroidism with dyslipidemia with traditional Chinese medicine.Materials and Methods:1.Use computer to search China Knowledge Network(CNKI),Wanfang database(WANFINA DATA),VIP database(CQVIP),Chinese Biomedical Literature Database(CBMdisc),and the time for document retrieval is from the date of establishment of each database to July 2020 15th.2.Set the inclusion criteria and exclusion criteria,and screen out the literature that meets the requirements of traditional Chinese medicine combined with L-T₄intervention in the treatment of hypothyroidism with dyslipidemia.3.Extract the basic information of the literature,and use the modified Jadad scale to score the quality of the literature.4.Extract data from the literature,enter it into WPS-2019 software for statistics,use Revman5.3 software to conduct Meta analysis on the data in WPS-2019,evaluate the efficacy of traditional Chinese medicine intervention based on the forest map of the data,and evaluate the publication of the data based on the funnel diagram Risk of bias.Result:1.Literature search results:Through searching in China National Knowledge Network,Wanfang database,VIP database,and China Biomedical Literature Database,26 documents that meet the conditions were obtained.2.The basic information results of the literature:26 literatures used a randomized control method to conduct the trial involving 2109 patients,including1056 patients in the treatment group and 1053 patients in the control group.There was no statistical difference in the basic information characteristics of patients in various literatures,such as gender,age,and disease course(P>0.05).3.Document quality evaluation results:20 of the 26 documents are low-quality documents(score?3 points),and 6 are high-quality documents(score?4 points).4.Clinical data results:Meta analysis results show that 1)improve the total clinical effective rate[OR=3.55,95%CI(2.72,4.64),P<0.00001],the efficacy of traditional Chinese medicine combined with L-T₄is better than the pure L-T₄group,And the clinical trials have good homogeneity;reduce the total score of TCM syndrome[SMD=-1.47,95%CI(-1.84,-1.10),P<0.00001],the efficacy of TCM combined with L-T₄is better than that of L-T₄alone.However,the data is highly heterogeneous,and the sensitivity analysis of the literature shows that the results are relatively stable.2)Improve the symptoms of traditional Chinese medicine:improve the symptoms of chills[MD=-0.70,95%CI(-0.79,-0.61),P<0.00001],the effect is better than the simple L-T₄group,and the clinical trials have good homogeneity Sex.In terms of relieving facial and limb edema[MD=-0.50,95%CI(-0.73,-0.27),P<0.00001],the intervention of traditional Chinese medicine has a good effect compared with the L-T₄group alone,but the data has higher heterogeneity The source of the heterogeneity was found through the analysis of the literature,indicating that the data has good reliability.3)Improve the level of thyroid function:FT₃index effect combined amount result is[SMD=1.15,95%CI(0.85,1.46),P<0.00001],TSH index effect combined amount result is[SMD=-1.48,95%CI(-1.91,-1.05),P<0.00001],the combined effect of FT₄index results is[SMD=1.23,95%CI(0.92,1.54),P<0.00001],both are statistically significant,but the heterogeneity is high,The sensitivity analysis showed that the results were relatively stable,indicating that the use of traditional Chinese medicine on the basis of L-T₄has better intervention effects on the above indicators than the L-T₄group alone.4)Improve blood lipid level:The combined amount of TC index effect is[MD=-1.07,95%CI(-1.28,-0.86),P<0.00001],the combined amount of TG index effect is[MD=-0.67,95%CI(-0.83,-0.52),P<0.00001],the above results are statistically different(P<0.05),the heterogeneity of each index is high,the analysis of the forest diagram shows that the 95%CI of each index data is mostly not Intersecting the invalid line and performing sensitivity analysis at the same time,the results of each index are relatively stable,indicating that the use of traditional Chinese medicine on the basis of L-T₄is better than the pure L-T₄group.5.Publication bias:A funnel chart analysis of the clinical effectiveness of 26articles shows that the distribution of scattered points is relatively even and symmetrical,and a small number of scattered points are unevenly distributed,indicating that the overall publication bias is not significant.However,other outcome indicators have certain publication bias,which may be related to the low quality of the literature.6.Adverse reactions and safety index results:8 documents did not describe this result;11 documents did not see clear adverse reactions,7 documents described adverse reactions in detail;16 documents had normal safety indicators,and 2documents reported Abnormal liver function.Conclusion:1.Compared with L-T₄alone,traditional Chinese medicine combined with L-T₄can improve the clinical efficacy of patients with hypothyroidism and dyslipidemia.It is significantly better than the L-T₄control group in improving the levels of patients with TSH,FT₄,FT₃,TG,and TC.2.There are few high-quality literatures on hypothyroidism with dyslipidemia.