Clinical Observation Of Meishao Xiegan Decoction In The Treatment Of Diffuse Toxic Goiter With Exuberant Liver Fire

ObjectiveThe purpose of this research is to observe the efficacy and safety of Meishao Xiegan Decoction in the treatment of diffuse toxic goiter with excessive liver fire,to guide the feasibility and key points of clinical syndrome differentiation and treatment,and to explore the clinical value of this prescription in diffuse toxic goiter.Provide reference value for the clinical practice of traditional Chinese medicine in the disease,and expand the clinical application of traditional Chinese medicine.MethodsSeventy patients with diffuse toxic goite were divided into control group and observation group,35 cases in each group according to the inclusion standard.The control group was treated with methimazole,and the observation group was treated with Meishao Xiegan Decoction on the basis of the treatment of the control group,and the course of treatment was12 weeks.FT3,FT4,TSH,TRAB,25(OH)D,TCM syndrome score and safety indexes were compared between the two groups.All data were statistically analyzed by SPSS 23.0 statistical software to objectively evaluate the safety and efficacy of Meishao Xiegan Decoction in the treatment of patients with diffuse toxic goite with exuberant liver fire.Results1.A total of 70 cases were included in the two groups,65 cases were actually completed,the total abscission rate was 7.14%.In the control group,2 cases were abscission,and the abscission rate was 5.71%;In the observation group,3 cases were abscission,and the abscission rate was 8.57%;There was no significant difference in the abscission rate between the two groups.2.Comparison of data before treatment: Before treatment,there was no significant difference in gender,age,heart rate,FT3,FT4,TSH,TRAb,25(OH)D3 and TCM syndrome score between the two groups(P > 0.05).The treatment baseline of the two groups was uniform and comparable.3.Comparison of overall efficacy:The two groups of treatment programs have curative effect,and there is significant difference in the overall curative effect(P<0.05).And the recovery rate(9.38%)and markedly effective rate(18.75%)of the observation group were significantly higher than those of the control group(0%)and(9.09%),and the efficacy of Meishao Xiegan Decoction in the treatment of Graves’ disease was positive.4.Heart rate:There were statistically significant differences in heart rate between the two groups before and after treatment(P < 0.05),and there were statistically significant differences between the two groups after treatment(P < 0.05),and the heart rate in the observation group(75.41 beats/min)was lower than that in the control group(78.58beats/min).5.Thyroid function:Intra-group comparison of FT3,FT4,TSH and TRAb before and after treatment of Observation group and control group,the differences were statistically significant(P<0.05);After treatment,FT3,FT4 and TSH were compared between the two groups,and the differences were statistically significant(P<0.05),And the average level of FT3 and FT4 in the observation group was lower than that in the control group,and the average level of TSH was higher than that in the control group;There was no significant difference in TRAb level between the two groups after treatment(P>0.05).6.25(OH)D:The levels of 25(OH)D in the observation group and the control group before treatment were lower than the normal reference value,and intra-group comparison of the two group before and after treatment,the difference was statistically significant(P <0.05);After treatment,the difference between the two groups was statisticallysignificant(P<0.05),and the average level of 25(OH)D in the observation group was 26.85ng/ m L,which was better than 24.97ng/ml in the control group.7.TCM syndrome points:There was statistical significance in the comparison of TCM syndrome scores between the two groups after treatment(P < 0.05).In the comparison of individual symptom scores,there were significant differences in irritability,dry and/or bitter mouth,palpitations and insomnia improvement between the two groups after treatment(P<0.05).And there was no significant difference between the groups after the treatment of the remaining symptoms(P>0.05).8.Security aspect:There were no adverse events and safety problems in the control group and observation group.The safety indexes such as blood routine(WBC,NE#),liver function(ALT,SAT,TBIL,DBIL,IBIL),renal function(BUN,CR)between the two groups before and after treatment were all within the normal reference value range,the difference was not statistically significant(P>0.05).Conclusion1.Meishaoxiegan Yin has better effect on improving clinical symptoms,thyroid function and TCM syndrome score of Graves’ disease than methimazole alone,and does not increase the incidence of adverse reactions.Its clinical efficacy and safety are worth affirming.2.Meishaoxiegan Decoction can increase the level of 25(OH)D in Graves’ patients with exuberant liver fire.