Study On The Adjuvant Therapeutic Effect Of Vitamin D On Hashimoto’s Thyroiditis From The Perspective Of "Tonifying Kidney"

Objective:1.Study on the clinical characteristics of patients with Hashimoto’s thyroiditis(HT)hypothyroidism: to study the number and degree of kidney deficiency in patients with HT hypothyroidism,to explore the number and degree of vitamin D deficiency,and to compare the differences and correlations of clinical data in different groups.2.The role of vitamin D in the adjuvant treatment of HT hypothyroidism: the patients were treated with intervention.The changes in TPOAB and TGAB antibody titers after treatment,as well as the improvement of the degree of kidney deficiency,were analyzed to explore whether vitamin D can achieve the adjuvant treatment effect on HT by "tonifying the kidney".To clarify the scope of TCM clinical application of vitamin D,to provide clinical evidence-based medical evidence for the treatment of HT with integrated TCM and Western medicine.Method:1.Study on the clinical characteristics of patients with HT hypothyroidism: 79 patients with HT hypothyroidism who met the criteria of intake and discharge were included and grouped according to TCM syndrome differentiation and serum vitamin D levels to study the differences and correlations of clinical data.2.The role of vitamin D in the adjuvant treatment of HT hypothyroidism: 79 patients were given a 4-week intervention treatment.The vitamin D deficiency group received thyroid hormone supplementation therapy and exogenous vitamin D supplementation therapy(oral vitamin D drops).The patients in the normal vitamin D group received thyroid hormone supplementation therapy.The differences in clinical data before and after intervention treatment,as well as the improvement of vitamin D on antibody titers and the degree of kidney deficiency were analyzed.Result:1.Clinical characteristics of patients with HT hypothyroidism:(1)A total of 79 patients with HT hypothyroidism were included,including 65 patients in the kidney deficiency group and 14 patients in the non-kidney deficiency group,with kidney deficiency syndrome accounting for 82.28%;there were statistical differences in age and weight between the two groups.The average vitamin D level was 42.5 nmol/L,which was lower than the lower limit of normal serum vitamin D level of 75 nmol/L,and the difference was statistically significant.Among them,there were 74 patients with vitamin D deficiency and 5 patients with normal vitamin D,and the proportion of vitamin D deficiency was 93.67%,there was a statistically significant difference in vitamin D levels between the two groups.(2)Among the 74 patients with vitamin D deficiency,there were 61 patients with kidney deficiency syndrome and 13 patients with non-kidney deficiency syndrome;in terms of vitamin D levels,patients with kidney deficiency syndrome had more severe vitamin D deficiency than those with non-kidney deficiency syndrome,and the difference was statistically significant.Among 65 patients with kidney deficiency syndrome,age and vitamin D level were the two risk factors affecting the degree of kidney deficiency,age was positively correlated with the degree of kidney deficiency,and vitamin D level was negatively correlated with the degree of kidney deficiency.Vitamin D level was independent of the degree of kidney deficiency risk factors.2.The role of vitamin D in the adjuvant therapy of HT hypothyroidism:(1)After the intervention treatment of 79 patients,although the vitamin D deficiency group received 4 weeks of vitamin D supplementation therapy(only oral vitamin D drops,and all lighting methods were judged to be ineffective),the serum vitamin D level was still lower than that of vitamin D normal group,and the difference was statistically significant.The titers of TPOAB and TGAB antibodies in 74 patients with vitamin D deficiency decreased after intervention treatment,but the difference was not statistically significant compared with before intervention treatment.(2)TPOAB and TGAB were decreased in 61 patients in the kidney deficiency group after intervention treatment,and the difference was statistically significant;13 patients in the non-kidney deficiency group had no change in TPOAB and TGAB after intervention treatment.In terms of the kidney deficiency group,the curative effect was better than that of the non-kidney deficiency group.(3)After vitamin D supplementation in the kidney deficiency group,the kidney deficiency syndrome scores decreased,and the difference was statistically significant.Vitamin D supplementation could significantly improve the degree of kidney deficiency.Conclusion:1.Clinical characteristics of patients with HT hypothyroidism:(1)In patients with HT hypothyroidism,kidney deficiency syndrome and vitamin D deficiency are common.It is suggested to pay attention to vitamin D supplementation in the diagnosis and treatment of HT hypothyroidism.(2)The older the age,the more serious the degree of kidney deficiency.The lower the serum vitamin D level,the more serious the degree of kidney deficiency.The serum vitamin D level is an independent risk factor for the degree of kidney deficiency.In the treatment of HT hypothyroidism,attention should be paid to syndrome differentiation,especially for patients with kidney deficiency syndrome,vitamin D should be supplemented in time.2.The role of vitamin D in the adjuvant therapy of HT hypothyroidism:(1)After 4 weeks of intervention and treatment for vitamin D deficiency patients,the serum vitamin D level is still lower than the lower limit of the normal value,which may be related to taking only vitamin D drops.It is suggested that when supplementing vitamin D,not only oral vitamin D drops are needed,effective lighting is even more essential.(2)Vitamin D can significantly improve the antibody titer and the degree of kidney deficiency in patients with HT hypothyroidism and kidney deficiency.The curative effect on the patients in the kidney deficiency group is better than that in the non-kidney deficiency group.