Observation On The Efficacy Of Soothing The Liver, Strengthening The Spleen And Tonifying The Kidney In The Treatment Of 40 Patients With Hashimoto's Thyroiditis And Hypothyroidis

Purpose:To observe the changes of clinical symptoms,total score of TCM syndromes,thyroid autoantibody titers(TGAb,TPOAb)and L-T4 dose in patients with normal thyroid function(FT4,FT3 and TSH)treated with Hashimotothyroiditis accompanied by hypothyroidism by the method of regulating liver,strengthening spleen and tonifying kidney.In order to further explore the clinical efficacy and related mechanism of Traditional Chinese medicine in the treatment of Hashimoto with hypothyroidism and provide new ideas for systematic and comprehensive diagnosis and treatment.Material and method:A total of 40 patients who met the inclusion criteria and came to the Outpatient department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from November 2020 to February 2022 were selected.A two-stage,24-week efficacy observation was conducted using a self-controlled study method.The first stage(the first 12 weeks)was treated with western medicine(Levothyroxine Sodium Tablet)without setting the elution period.The second stage(the last 12 weeks)was treated with Levothyroxine Sodium Tablet combined with granules which was mainly composed of liver-soothing,spleen-nourishing and kidney tonifying method.After all the two stages of treatment,relevant data were collected for statistical analysis.Results:Statistical analysis showed that the total score of TCM syndromes,TSH,TGAb,TPOAb and other data of the two stages followed normal distribution(P > 0.05),which could be compared.(1)From the perspective of TCM syndrome efficacy: TCM single main symptom score(emotional restlessness,fatigue,etc.)decreased after two stages of treatment compared with before treatment,and symptom improvement in the second stage was significantly better than that in the first stage,the difference was statistically significant(P <0.05);The total score of TCM syndromes decreased slightly before and after the first stage of treatment,but decreased significantly before and after the second stage of treatment,with statistical significance(P < 0.05).The total effective rate of the second stage(84.62%)was significantly higher than that of the first stage(7.69%)(P < 0.05),and the difference was statistically significant.(2)From the perspective of clinical efficacy(TGAb,TPOAb antibody titer change): compared with the clinical efficacy of the two stages,the total effective rate of92.31% in the second stage was significantly higher than that of 10.26% in the first stage(P <0.05),and the difference between the two stages was statistically significant(P < 0.05).(3)From the perspective of thyroid hormone supplement dose: In the first stage,there was almost no decrease in oral L-T4 dose before and after treatment(P > 0.05),and the reduction of L-T4 dose after intervention in the second stage was significant compared with that before treatment(P < 0.05).The total effective rate of L-T4 reduction in the second stage was82.05%,which was higher than the total effective rate of 5.13% in the first stage.There was statistically significant difference between the two stages(P < 0.05).(4)From the perspective of safety indicators,no abnormal changes were observed in the safety indicators such as liver function,kidney function and blood routine monitored before enrollment after two stages of treatment,and no obvious adverse reactions occurred.Conclusion:The treatment of Hashimoto’s thyroiditis with hypothyroidism by the method of soothing the liver,strengthening the spleen and tonifying the kidney has good clinical efficacy,especially in improving the symptoms and signs of Traditional Chinese medicine,reducing the daily oral dose of L-T4 and reducing the titer of serum thyroid-related antibodies,etc.It is safe and effective and worthy of further research and promotion.