桥本甲状腺炎并发甲状腺毒症人群临床症状及证型分布规律研究

BackgroundTraditional Chinese Medicine has a systematic understanding of the occurrencedevelopmentdiagnosis and treatment of Hashimoto's thyroiditis complicated with thyrotoxicosis. Howeverat presentthere are few studies on the clinical symptoms and syndrome distribution of TCM in this disease populationand there is also a lack of description of the syndrome distribution and syndrome diagnostic criteria of this disease in the national industry standards. ObjectiveUsing factor analysis combine with cluster analysis to explore the distribution of clinical symptoms and syndromes of Hashimoto's thyroiditis complicated with thyrotoxicosisprovide a basis for clinical syndrome differentiation and promote the standardization of Hashimoto's thyroiditis complicated with thyrotoxicosis syndrome. MethodsFrom December 2020 to December 2021171 patients with Hashimoto's thyroiditis complicated with thyrotoxicosis who met the diagnostic criteria in the outpatient department of thyroid disease of Dongcheng DistrictTongzhou District of Dongzhimen Hospital of Beijing University of Chinese Medicine and Sun Simiao Hospital was collected. The symptomssignstonguepulse and other four diagnostic information were collected by using the' four diagnostic information collection table of Hashimoto's thyroiditis complicated with thyrotoxicosis'. Based on factor analysis and cluster analysisthe symptoms and syndrome distribution of Hashimoto's thyroiditis complicated with thyrotoxicosis were studied. ResultsAmong the 171 patients with Hashimoto's Thyroiditis complicated with thyrotoxicosisthere were 17 males and 154 femaleswith an average age of39.9813.30 years. Patients aged 20-60 years accounted for 87.72%. The symptoms with high frequency in the distribution of symptoms were fatiguepalpitationirritability or impatience. Signs were swelling of the neckfinger tremor. The tongue image with higher frequency had redthin tongue and tooth marks on the tongue. The pulse condition was pulse string and pulse number. Factor analysis of 82 four diagnostic items of the questionnaire was collectedand 25 common factors were extracted. The cumulative variance contribution rate was 70.562%and 62 meaningful symptoms were screened out. The 25 common factor results obtained by factor analysis were used as variables to perform R-type system cluster analysisand a total of 5 types of syndrome types were obtainednamelypattern of phlegm congealing due to liver depressionpattern of yin deficiency with effulgent firepattern of yang deficiency in spleen and kidneypattern of qi stagnation due to liver depressionpattern of dual deficiency of qi and nutrient phases. ConclusionThe basic traditional chinese medicine syndromes of Hashimoto's thyroiditis complicated with thyrotoxicosis can be divided into pattern of phlegm congealing due to liver depressionpattern of yin deficiency with effulgent firepattern of yang deficiency in spleen and kidneypattern of qi stagnation due to liver depressionpattern of dual deficiency of qi and nutrient phases.