中国全科医学2024，Vol.27Issue(21)：2630-2638,9.DOI:10.12114/j.issn.1007-9572.2023.0599
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
Study on the Distribution of Clinical Symptoms and Syndromes of Hashimoto's Thyroiditis Complicated with Thyrotoxicosis
摘要
Abstract
Background Traditional Chinese Medicine(TCM)has a systematic understanding of the occurrence,development,diagnosis and treatment of Hashimoto's thyroiditis complicated with thyrotoxicosis.However,at present,there are few studies on the clinical symptoms and syndrome distribution of TCM in this disease population,and there is also a lack of description of the syndrome distribution and syndrome diagnostic criteria of this disease in the national industry standards.Objective Using factor analysis combine with cluster analysis to explore the distribution of clinical symptoms and syndromes of Hashimoto's thyroiditis complicated with thyrotoxicosis,provide a basis for clinical syndrome differentiation and promote the standardization of Hashimoto's thyroiditis complicated with thyrotoxicosis syndrome.Methods From December 2020 to December 2021,171 patients with Hashimoto's thyroiditis complicated with thyrotoxicosis who met the diagnostic criteria in the outpatient department of thyroid disease of Dongcheng District,Tongzhou District of Dongzhimen Hospital,Beijing University of Chinese Medicine and Sunsimiao Hospital was collected.The symptoms,signs,tongue,pulse 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 analysis,the symptoms and syndrome distribution of Hashimoto's thyroiditis complicated with thyrotoxicosis were studied.Results Among the 171 patients with Hashimoto's thyroiditis complicated with thyrotoxicosis,there were 17 males and 154 females,with an average age of(39.98±13.30)years.Patients aged 20-60 years accounted for 87.72%.The symptoms with high frequency in the distribution of symptoms were fatigue,palpitation,irritability or impatience.Signs were swelling of the neck,finger tremor.The tongue image with higher frequency had red,thin tongue and tooth marks on the tongue.The moss were white and thin.The pulse condition were pulse string and pulse number.Factor analysis of 82 four diagnostic items of the questionnaire was collected,and 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 analysis,and a total of 5 types of syndrome types were obtained,namely:pattern of phlegm congealing due to liver depression,pattern of yin deficiency with effulgent fire,pattern of yang deficiency in spleen and kidney,pattern of qi stagnation due to liver depression,pattern of dual deficiency of qi and nutrient phases.Conclusion The basic TCM syndromes of Hashimoto's thyroiditis complicated with thyrotoxicosis can be divided into pattern of phlegm congealing due to liver depression,pattern of yin deficiency with effulgent fire,pattern of yang deficiency in spleen and kidney,pattern of qi stagnation due to liver depression,pattern of dual deficiency of qi and nutrient phases.关键词
桥本病/桥本甲状腺炎/桥本甲状腺炎并发甲状腺毒症/中医证候/分布规律/因子分析/聚类分析Key words
Hashimoto disease/Hashimoto thyroiditides/Hashimoto thyroiditis complicated with thyrotoxicosis/Traditional Chinese Medicine syndrome/Regularity of distribution/Factor analysis/Cluster analysis分类
医药卫生引用本文复制引用
葛亚雪,丁治国,陈晓珩,李会龙,祁烁,户蕊..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[J].中国全科医学,2024,27(21):2630-2638,9.基金项目
陕西省科技厅重点研发计划项目(2023-ZDLSF-56) （2023-ZDLSF-56）
陕西省中医药管理局项目(2021-GJ-LC002,SZY-KJCYC-2023-074,2022-QCYZH-043) （2021-GJ-LC002,SZY-KJCYC-2023-074,2022-QCYZH-043）
北京中医药大学孙思邈研究院项目(SSMYJY-3-2021-05) （SSMYJY-3-2021-05）
