What Is Chronic Thyroiditis?

The thyroid gland is the largest endocrine gland of the human body. It is located under the thyroid cartilage directly next to the third trachea and in front of the four cartilage rings. It consists of both lateral leaves and isthmus. The average weight is about 20-25g. Women are slightly larger and slightly heavier. There are 4 parathyroid glands and recurrent laryngeal nerve behind the thyroid. The blood supply has four arteries: up, down, left, right, and so on. The thyroid is rich in blood supply. The glands are dominated by the sympathetic and vagus nerves of the cervical sympathetic ganglia. The main function of the thyroid is to synthesize thyroid hormones and regulate the body's metabolism. There are about 100 in daily food. -200g inorganic iodine compound, which is absorbed into the blood circulation through the gastrointestinal tract, quickly concentrates the thyroid gland, and the iodine stored in the gland is about 1/5 of the whole body. After the iodide enters the cell, through the action of oxidase, the active iodine is rapidly combined with the tyrosine group on the thyroglobulin molecule in the glial cavity to form monoiodotyrosine (MIT) and diiodotyrosine ( DIT), iodized tyrosine couples MIT and DIT to form thyroxine (T4), and MID and DIT couple to form triiodothyronine (T3) through the action of oxidase, stored in the colloidal cavity, Synthetic thyroxine (T4) and triiodothyronine (T3) are secreted into the blood circulation and mainly bind to thyroxine-binding globulin (TBG) in the plasma to facilitate the transport and regulation of thyroxine concentration in the blood. Thyroxine (T4) is deiodinated in peripheral tissues to form stronger biologically active T3 and inactive rT3, respectively. The removed iodine can be reused. Therefore, blood T4, T3, and rT3 increased during hyperthyroidism, and all of them were below normal when hypothyroidism occurred. Thyroxine secretion is secreted by pituitary cells and TSH is regulated by the adenylyl cyclase-cAMP system. TSH is controlled by TRH secreted by the hypothalamus, which forms the hypothalamic-pituitary-thyroid axis and regulates thyroid function.

Chronic thyroiditis

Chronic lymphocytic thyroiditis, also known as Hashimoto's disease or Hashimoto's thyroiditis, is caused by immune dysfunction and produces immune inflammation against its own tissues.

Introduction to chronic thyroiditis disease

Introduction of chronic thyroiditis tissue

The thyroid gland is the largest endocrine gland of the human body. It is located under the thyroid cartilage directly next to the third trachea and in front of the four cartilage rings. It consists of both lateral leaves and isthmus. The average weight is about 20-25g. Women are slightly larger and slightly heavier. There are 4 parathyroid glands and recurrent laryngeal nerve behind the thyroid. The blood supply has four arteries: up, down, left, right, and so on. The thyroid is rich in blood supply. The glands are dominated by the sympathetic and vagus nerves of the cervical sympathetic ganglia. The main function of the thyroid is to synthesize thyroid hormones and regulate the body's metabolism. There are about 100 in daily food. -200g inorganic iodine compound, which is absorbed into the blood circulation through the gastrointestinal tract, quickly concentrates the thyroid gland, and the iodine stored in the gland is about 1/5 of the whole body. After the iodide enters the cell, through the action of oxidase, the active iodine is rapidly combined with the tyrosine group on the thyroglobulin molecule in the glial cavity to form monoiodotyrosine (MIT) and diiodotyrosine ( DIT), iodized tyrosine couples MIT and DIT to form thyroxine (T4), and MID and DIT couple to form triiodothyronine (T3) through the action of oxidase, stored in the colloidal cavity, Synthetic thyroxine (T4) and triiodothyronine (T3) are secreted into the blood circulation and mainly bind to thyroxine-binding globulin (TBG) in the plasma to facilitate the transport and regulation of thyroxine concentration in the blood. Thyroxine (T4) is deiodinated in peripheral tissues to form stronger biologically active T3 and inactive rT3, respectively. The removed iodine can be reused. Therefore, blood T4, T3, and rT3 increased during hyperthyroidism, and all of them were below normal when hypothyroidism occurred. Thyroxine secretion is secreted by pituitary cells and TSH is regulated by the adenylyl cyclase-cAMP system. TSH is controlled by TRH secreted by the hypothalamus, which forms the hypothalamic-pituitary-thyroid axis and regulates thyroid function.

Introduction to chronic thyroiditis disease

1: Chronic lymphatic thyroiditis, also known as autoimmune thyroiditis, Hashimoto's disease. It is the most common type of thyroiditis. 90% of patients are women, more common in 30--50 years old, but it can also occur in children and adolescents. The clinical manifestations of the disease are: slow onset, patients generally do not have special feelings, often found involuntarily goiter, usually diffuse to the shape of swelling, but also one side swelling is more obvious, most cases are different, a few The case shows slight pain, and the symptoms of compression are not obvious. The texture is hard like a rubbery touch, the surface is smooth and lobular, often without obvious nodules, and there is no adhesion with surrounding tissues. It can move up and down with swallowing movements. Early thyroid function is more In the normal range, a few people can see slight hyperthyroidism, such as nervousness, palpitations, and fever. Generally, there is no spontaneous remission. As the disease progresses, when the thyroid damage reaches a certain level, more than half of the patients may develop symptoms of hypothyroidism in the later stage. Cold, fatigue, weight gain, etc., some cases progress from diffuse swollen to nodular, a small number of advanced patients with a large amount of fibrosis in the thyroid body, it is as hard as stone, often adhere to the surrounding tissues, and can develop progressive symptoms of life, Difficulty breathing (especially during manual labor), difficulty swallowing, hoarseness, etc. Traditional Chinese medicine is called "Kan Tuoma", "Shi Zhi", "Dang Qi", etc.

Chronic lymphocytic thyroiditis, also known as Hashimoto's thyroiditis, Hashimoto's disease, and autoimmune thyroiditis, is an autoimmune disease that has a tendency to develop hypothyroidism. It is more common in women aged 30 to 50 years, with hidden onset, slow development and a long course of disease. Most patients are asymptomatic at the beginning, and the earliest symptoms are fatigue. The main symptoms are slow and the disease course is long. Most patients are asymptomatic at first, and the earliest symptoms are fatigue. Mainly manifested as goiter, most of which are diffuse, and a few can be nodular and hard. With the development of the disease, hypothyroidism and myxedema may appear.

Patients suspected of Hashimoto's disease can be examined for thyroid function, TGAb (thyroglobulin antibody), TPOAb (thyroid peroxidase antibody), thyroid scan and other tests. If necessary, a thyroid biopsy can be performed to confirm.

Classification of chronic thyroiditis

A brief introduction to chronic thyroiditis

1. ^[1] Chronic lymphocytic thyroiditis, also known as Hashimoto's thyroiditis or autoimmune thyroiditis, is an autoimmune disease, more common in middle-aged women Clinically, it is diffuse thyroid enlargement. In the later stage, there is generally a manifestation of hypothyroidism. TSH is high, T3 and T4 are low, and a series of autoantibodies appear in the patient's blood.

2. Fibrous thyroiditis (fibrous thyroiditis) Also known as Riedel's goiter or chronic woody thyroiditis (chronic woody thyroiditis), the cause is unknown and rare. The male to female ratio is 1: 3, and the age is 30 to 60 years. Clinically, the early symptoms are not obvious, the function is normal, the late thyroid function is low, and the fibrous scar tissue compression can produce hoarseness, breathing and swallowing difficulties.

Onset of chronic thyroiditis

Chronic lymphocytic thyroiditis, also known as Hashimoto's disease, was named after Dr. Hashimoto's first report from Japan. Its long course is a common endocrine disease. The disease is more common in women and occurs more often between 30-50 years of age. Its signals are:

There is often no special sensation at the beginning, but it can be seen that the thyroid gradually increases symmetrically. When the thyroid is destroyed to a certain degree, most patients will experience fatigue, drowsiness, fear of coldness, poor memory, mental retardation, pale skin with cool, dry and thick, loss of appetite and weight gain, breast swelling, but no depression. In recent years, it has been found that teenage middle school students suffer from this disease, but it is easy to be ignored, so it should be taken seriously.

In the past, oral thyroid tablets and adrenocortical hormones were mostly used to treat this disease. Now, more Chinese and western medicine are used in the country to reduce recurrence and have no side effects.

Characteristics of chronic thyroiditis

The incidence of chronic lymphocytic thyroiditis is second only to toxic diffuse goiter. More common in women between 30-50 years old, the ratio of female to male is 20: 1. The onset of the patient is concealed, the disease progresses slowly, and it is often diagnosed by further examination due to the occasional discovery of goiter, or when hypothyroidism occurs. There are many diffuse thyroid enlargement, isthmus enlargement is usually more obvious, and there may be cone leaf enlargement, which is one of the characteristics of this disease; the two thyroid leaves may be uneven in size, may have nodules, and the texture is hard and tough, such as Rubber-like; the thyroid is generally painless and has no adhesion to surrounding tissues; individual patients may have symptoms similar to subacute thyroiditis such as rapid goiter, pain, and tenderness.

During the development of Hashimoto's disease, there may be symptoms of hyperthyroidism, called Hashimoto's hyperthyroidism, and the incidence rate is about 20% -25% of Hashimoto's disease. Most of the causes are inflammatory damage to the thyroid gland and increased release of thyroid hormone into the blood. Therefore, hyperthyroidism is transient; if affected by iodine intake and thyroid inflammation and repair, hyperthyroidism or hyperthyroidism and hyperthyroidism may occur repeatedly. Low alternates. A small number of Hashimoto's hyperthyroidism is caused by Hashimoto's disease with toxic diffuse goiter, which accounts for 0.3% -7.6% of Hashimoto's disease; patients with hyperthyroidism can persist for a long time, and can be accompanied by the performance of typical toxic diffuse goiter Such as exophthalmos and anterior tibial myxedema, blood TSI positive. Patients can develop onset of either of the two diseases, and clinically, one of them can be the main manifestation; for example, the symptoms of hyperthyroidism can last for months to years, but due to the constant destruction of thyroid tissue, they eventually develop into Hypothyroidism.

Chronic lymphocytic thyroiditis is a more common autoimmune thyroid disease. The disease is more common in middle-aged women and has a family genetic phenomenon.

Points of diagnosis for chronic thyroiditis

First, the onset is slow, the goiter can reach 2 to 4 times the normal, the surface is smooth, tough and rubber-like, sometimes nodular, and generally no tenderness.

Second, thyroid function can be normal, or transient hyperthyroidism appears in the early stage, due to more damage to the glands in the later stage, hypothyroidism can appear.

Third, laboratory inspection

1. Serum thyroid microsomal antibodies (TMAb) and thyroid leukoantibodies (TGAb) are positive, and most of them show high titers, such as 60% twice in a row, even if the symptoms are not typical can be diagnosed.

2. Thyroid biopsy: Fine needle aspiration shows a large number of lymphocytes and plasma cells, and eosinophilic vesicle cells may appear.

3 The results of thyroid function tests depend on the stage of the disease. When a few patients may have transient hyperthyroidism in the early stages of onset, blood T3, T4, FT3, and FT4 may increase. Early thyroid function is completely normal in most patients. In the future, T3 and T4 may be normal, but the thyroid stimulating hormone (TSH) is elevated, or the TSH stimulation test has a high response. At this time, the thyroid iodine 131 uptake rate can also be increased, but it can be affected by T3. Inhibition test, this point can be identified with Graves disease. When hypothyroidism occurs later in the disease, FT4, T4, FT3, and T3 decrease, TSH increases, and thyroid iodine 131 uptake decreases. [Treatment principles]

Diagnosis of chronic thyroiditis disease

Review of chronic thyroiditis

Chronic lymphatic thyroiditis is also known as Hashimoto disease or ^[2] Hashimoto's thyroiditis, autoimmune thyroiditis. Because the pathogenesis of this disease is related to autoimmunity, it is also called autoimmune thyroiditis. The onset of this disease is slow and there is a tendency to develop hypothyroidism. Some authors estimate that the incidence of this disease is similar to that of Graves disease.

This disease is believed to be caused by insufficient congenital endowment, due to poor mood, liver failure, liver stagnation, spleen deficiency, abnormal fluid delivery, condensed into sputum, and knotted before the neck. Or the cause of chronic illness is debilitating. There is evidence of deficiency of spleen and kidney. Rickets are mainly swollen in front of the neck, tough and painless, or nodules.

Clinical manifestations of chronic thyroiditis

1. The slow goiter is usually without special discomfort, some may have pharyngeal discomfort, and a few have thyroid pain.

2. There are several special cases

Hyperthyroidism, also known as Hashimoto's hyperthyroidism;

primary hypothyroidism;

Subacute thyroiditis;

Pseudohyperthyroidism or hypothyroidism (the clinical manifestations of hyperthyroidism or hypothyroidism, but the experimental examination is not supported);

Subclinical hypothyroidism (no clinical manifestations of hypothyroidism, but elevated TSH or TRH stimulation test showed high response).

3 On physical examination, the thyroid gland is small or mild to moderately swollen. The quality is tough, such as rubber, and the surface is smooth. It can also be nodular.

Basic examination of chronic thyroiditis

1. Thyroid function tests vary according to the course of the disease.

(1) Serum T4 and T3 are normal in the early stage, but TSH is increased; serum T4 is decreased in the later stage, T3 is normal or decreased, and TSH is increased.

(2) The thyroid iodine uptake rate is normal or increased in the early stage, but can be inhibited by T3; the iodine uptake rate is reduced in the later stage, and TSH is not increased by injection.

2. Immunological examination of anti-thyroglobulin antibody (TGA) and anti-thyroid microsomal (peroxidase) antibody (TMA) titers significantly increased, both of which are greater than 50% (radio-immunoassay method) diagnostic significance , Can last for several years or more than ten years.

3 In other tests, the erythrocyte sedimentation rate increased to 100mm / h, serum albumin decreased, and r globulin increased.

Further examination of chronic thyroiditis

1. SPECT Thyroid scans are evenly or unevenly distributed and can appear as "cold nodules."

2. Pathological examination for patients with atypical clinical manifestations and low or negative antibody titers can be performed by fine needle aspiration cytology or tissue biopsy to confirm the diagnosis.

Points of diagnosis for chronic thyroiditis

1. Middle-aged women with diffuse thyroid enlargement and tough texture should be considered regardless of thyroid function.

2. Serum TGA and TMA titers were significantly increased (> 50%), and the diagnosis was basically confirmed.

3 Atypical clinical manifestations require antibody titers> = 60% for two consecutive times, while those with hyperthyroidism require antibody titers> = 60 for more than six months.

4 The disease needs to be distinguished from thyroid cancer, which is negative for antibodies. The literature reports that the incidence of thyroid cancer in this disease is 5% -17%.

The onset of chronic lymphocytic thyroiditis is relatively hidden

Chronic lymphocytic thyroiditis, also known as Hashimoto's disease or Hashimoto's thyroiditis, autoimmune thyroiditis, is caused by immune dysfunction and produces immune inflammation against its own tissues. It is more common in women aged 30 to 50 years, with hidden onset, slow development and a long course of disease. Most patients are asymptomatic at the beginning, and the earliest symptoms are fatigue. The main symptoms are slow and the disease course is long. Most patients are asymptomatic at first, and the earliest symptoms are fatigue. Mainly manifested as goiter, most of which are diffuse, and a few can be nodular and hard. With the development of the disease, hypothyroidism and myxedema may appear.

Patients suspected of Hashimoto's disease can be examined for thyroid function, TGAb (thyroglobulin antibody), TPOAb (thyroid peroxidase antibody), thyroid scan and other tests. If necessary, a thyroid biopsy can be performed to confirm.

The onset of this disease is relatively insidious, which means that it is difficult to know when it is. Many patients only found the goiter by accident, and they didn't know they had the disease until they went to the hospital. In the early stages of the disease, there was a goiter, and the degree of swelling was very different. The touch felt harder. The surface could be smooth or non-smooth, and sometimes many nodules could be touched. Generally, there is no pain or tenderness in the thyroid area. Early thyroid function tests (such as serum T3 and T4 measurements, thyroid iodine 131 iodine determination, etc.) were not found abnormal.

With the further development of the disease, symptoms of hypothyroidism, such as fear of cold, swelling, loss of appetite, constipation, and rough skin, may occur over several years or longer. Checking thyroid function at this time can further confirm that the patient has hypothyroidism. Whether early in the disease or later, blood thyroglobulin antibodies and thyroid microsomal antibodies can often be found to be positive, and thyroid scans can reveal that the thyroid's radioactive distribution is relatively sparse.

Due to the insidious onset, many patients were found to have chronic lymphocytic thyroiditis due to hypothyroidism. A few patients may have transient symptoms of hyperthyroidism at some stage.

Clinical manifestations of chronic thyroiditis

During the development of Hashimoto's disease, there may be symptoms of hyperthyroidism, called Hashimoto's hyperthyroidism, and the incidence rate is about 20% -25% of Hashimoto's disease. Most of the causes are inflammatory damage to the thyroid gland and increased release of thyroid hormone into the blood. Therefore, hyperthyroidism is transient; if affected by iodine intake and thyroid inflammation and repair, hyperthyroidism or hyperthyroidism and hyperthyroidism may occur repeatedly. Low alternates. A small number of Hashimoto's hyperthyroidism is caused by Hashimoto's disease with toxic diffuse goiter, which accounts for 0.3% -7.6% of Hashimoto's disease; patients with hyperthyroidism can persist for a long time, and can be accompanied by the performance of typical toxic diffuse goiter Such as exophthalmos and anterior tibial myxedema, blood TSI positive. Patients can develop onset of either of the two diseases, and clinically, one of them can be the main manifestation; for example, the symptoms of hyperthyroidism can last for months to years, but due to the constant destruction of thyroid tissue, they eventually develop into Hypothyroidism. Chronic lymphocytic thyroiditis, also known as Hashimoto's disease or Hashimoto's thyroiditis, is caused by immune dysfunction and produces immune inflammation against its own tissues.

The incidence of chronic lymphocytic thyroiditis is second only to toxic diffuse goiter. More common in women aged 35-55, the ratio of women to men is 20: 1. The onset of the patient is concealed, the disease progresses slowly, and it is often diagnosed by further examination due to the occasional discovery of goiter, or when hypothyroidism occurs. There are many diffuse thyroid enlargement, isthmus enlargement is usually more obvious, and there may be cone leaf enlargement, which is one of the characteristics of this disease; the two thyroid leaves may be uneven in size, may have nodules, and the texture is hard and tough, such as Rubber-like; the thyroid is generally painless and has no adhesion to surrounding tissues; individual patients may have symptoms similar to subacute thyroiditis such as rapid goiter, pain, and tenderness. During the development of Hashimoto's disease, there may be symptoms of hyperthyroidism, called Hashimoto's hyperthyroidism, and the incidence rate is about 20% -25% of Hashimoto's disease. Most of the causes are inflammatory damage to the thyroid gland and increased release of thyroid hormone into the blood. Therefore, hyperthyroidism is transient; if affected by iodine intake and thyroid inflammation and repair, hyperthyroidism or hyperthyroidism and hyperthyroidism may occur repeatedly. Low alternates. A small number of Hashimoto's hyperthyroidism is caused by Hashimoto's disease with toxic diffuse goiter, which accounts for 0.3% -7.6% of Hashimoto's disease; patients with hyperthyroidism can persist for a long time, and can be accompanied by the performance of typical toxic diffuse goiter Such as exophthalmos and anterior tibial myxedema, blood TSI positive. Patients can develop onset of either of the two diseases, and clinically, one of them can be the main manifestation; for example, the symptoms of hyperthyroidism can last for months to years, but due to the constant destruction of thyroid tissue, they eventually develop into Hypothyroidism.

The difference between chronic thyroiditis and lymphocytic thyroiditis

There are many similarities between this disease and lymphocytic thyroiditis, which are not easily distinguishable clinically. The main differences are: the disease spreads, invades, and adheres to surrounding tissues; the latter is limited to the thyroid; the disease has lymphocytic infiltration but does not form lymphoid follicles; the latter is the opposite the disease has significant fibrosis And glass-like change, hard; the latter does not.

TCM syndrome differentiation of chronic thyroiditis

Chinese medicine believes that the disease is due to the weakness of the body and the deficiency of righteousness. Talk, qi, and stasis become knots at the neck. Due to the accumulation of phlegm and blood stasis over time, it is bloated and hard. The phlegm stagnates and ignites the fire for a long time. When the phlegm fire disturbs the heart, you will see upset, palpitations, insomnia, and more dreams. If the disease is prolonged and the spleen and kidney are damaged for a long time, you may see chills and cold, limbs are not warm, hyposexuality, body fatness, etc., or bloated and hard for a long time, such as stone, obstructing the airway and glottis. Chest tightness, shortness of breath, hoarseness, and difficulty swallowing.

Chinese medicine treatment of chronic thyroiditis

Chronic thyroiditis

Main symptoms: bloated and tenacious, painless or occasional pain, menstrual bloating, chest tightness, too much breath, sternum and coordination between time and time, fluctuations in the condition are often related to emotions, pale tongue, thin white fur, and pulse strings. Governing Law: Regulating Qi and Stagnation, Resolving Phlegm and Eliminating Stagnation

Chronic thyroiditis

Main evidence: bloated, painless, palpitations, irritability, heat, sweating, insomnia, dreams, red tongue, thin yellow fur, pulse count. Governing Law: Clearing away heat and phlegm

Chronic thyroiditis

Main evidence: bloated for a long time, hard to touch like rubber or eagle like stone, feeling of menstrual pressure, chest tightness, suffocation, or poor breathing, blocking feeling when swallowing, pale tongue, or bruising, white fur, Pulse sinking or astringent. Governing law: qi and blood circulation, phlegm elimination

Chronic thyroiditis

Main evidence: bloated and hard, pale, cold chills, fatigue, fatigue, nausea, hoarseness, puffy limbs, women's amenorrhea, men's impotence, pale or dark tongue, thin white fur, veins Shen is weak. Governing method: spleen and nourishing qi, nourishing kidney and warming yang

Chronic thyroiditis

Main evidence: bloatedness persists for a long time, and the mass is as hard as a stone, or there are nodules on it, different, complexion, light, loss of appetite, fatigue, dizziness, shortness of breath, lazy menstrual flow or amenorrhea, pale tongue Thin, weak pulses. Governing Law: Yiqi Yangxue.

The disease can be divided into eight types:

(1) Hashimoto's hyperthyroidism: Patients have typical symptoms of hyperthyroidism and positive laboratory test results. Hyperthyroidism and Hashimoto's disease can coexist or occur successively, coexist with each other, and transform each other.

(2) Pseudohyperthyroidism: A few may have symptoms of hyperthyroidism, but there is no evidence of hyperthyroidism on thyroid function tests, and TGAb and TMAb are positive.

(3) Exophthalmia type: eyeballs are prominent, nail function can be normal, hyperactive or diminished.

(4) Subacute thyroiditis: acute onset, goiter and pain, accompanied by fever, and rapid erythrocyte sedimentation, but the iodine rate of 131 is normal or increased, and the thyroid antibody titer is positive.

(5) Adolescent type: accounts for about 40% of adolescent goiter, normal thyroid function, and low antibody titer.

(6) Type of fibrosis: the course is long, and there may be extensive or partial fibrosis of the thyroid gland, thyroid atrophy, and hypothyroidism.

(7) Accompanying thyroid adenoma or cancer: often solitary nodules with high TGAb and TMAb titers. (8) Accompanying other autoimmune diseases.

Treatment of chronic thyroiditis

Mild condition of chronic thyroiditis

Patients with mild goiter who are asymptomatic may not be treated and should be followed up. When the thyroid is significantly enlarged or has reduced thyroid function, even if only serum TSH increases, thyroid preparations should be given. Generally starting from a small dose, thyroid tablets are 20 to 40 mg daily, or L-T425 to 50 micrograms, and gradually increase to the maintenance amount to maintain TSH in the normal range. If the goiter is rapidly enlarged, or accompanied by pain, or has compression symptoms, glucocorticoids can be used for short-term treatment. Hashimoto's hyperthyroidism should be treated with low-dose antithyroid drugs and propranolol. Iodine 131 and surgery are generally not used to avoid severe hypothyroidism.

It can be treated with pure Chinese medicine prescription, and the treatment effect is stable and ideal.

Chronic thyroiditis

Traditional Chinese medicine or western medicine has its own advantages. The comprehensive treatment measures based on the combination of traditional Chinese medicine and western medicine have become one of the important topics of clinical research in recent years. It can be seen from the numerous traditional Chinese and western medicine treatment measures that traditional Chinese medicine and western medicine are used to treat thyroiditis. The general trend of thyroid diseases such as hypothyroidism, hypothyroidism, and hypothyroidism is the use of Western medicine replacement therapy to supplement thyroid hormone, combined with TCM syndrome differentiation and treatment to promote the recovery of thyroid function. Not only is it accepted by the majority of patients, but also confirmed by many cases, its efficacy is significantly better than that of western medicine alone.

Not only greatly reduces the amount of thyroxine medication and reduces the occurrence of side effects of western medicine, at the same time, Chinese medicine can better improve the clinical symptoms of patients, especially can cure thyroid diseases such as thyroiditis, hypothyroidism, hypothyroidism, etc., for patients to find Hope. For patients with crisis of thyroid diseases such as thyroiditis, hypothyroidism, and hypothyroidism, the method of integrated traditional Chinese and western medicine should be actively rescued to improve the efficacy and reduce mortality.

In the past, traditional western medicine was used for treatment, mostly life-long replacement therapy; pure Chinese medicine treatment and integrated traditional Chinese and western medicine treatment improved or even disappeared the clinical symptoms. The western medicine was gradually reduced until the western medicine was discontinued, and then the traditional Chinese medicine was used to consolidate the efficacy. Within, the amount of Chinese medicine can be reduced.

In short, the use of pure Chinese medicine, combined traditional Chinese and western medicine to treat thyroid diseases such as thyroiditis, hypothyroidism, and hypothyroidism is an ideal treatment method at present, and it is the hope for the radical cure of thyroid diseases such as thyroiditis, hypothyroidism, and hypothyroidism.

Chronic thyroiditis replacement therapy

At present, the treatment of thyroid diseases such as Hashimoto's disease, thyroiditis such as Hashimoto's thyroiditis, and thyroid tablets are often replaced by thyroid tablets, such as Eulerox, Jiaheng, thyroxine tablets, etc. Most patients need long-term or lifelong medication; thyroid hormone Although the treatment can replace the hypothyroidism of the patient, it has no effect on the immune abnormality and cannot reduce the level of antithyroid antibodies in the patient's serum. Surgery and radioactive iodine treatment will accelerate the onset and development of hypothyroidism, which is generally contraindicated.

The expert group used a combination of traditional Chinese and western medicine to treat thyroid diseases such as Hashimoto's disease and Hashimoto's thyroiditis, and has accumulated rich clinical experience. It summarized the method of warming the spleen and kidney with Chinese medicine, promoting blood circulation, removing blood stasis, and softening and solidifying. In principle, a good clinical effect has been achieved; the results of the study suggest that the combination of traditional Chinese and western medicine for the treatment of Hashimoto's disease, Hashimoto's thyroiditis and other thyroiditis is better than simply taking western medicine thyroxine tablets, and it can be better after adding Chinese medicine Improve the clinical symptoms and thyroid function of patients, reduce the enlargement of goiter, and reduce the high level of anti-thyroid autoantibodies in the patient's serum, improve the body's immune function, and reduce the dose of thyroid hormone replacement therapy, thus avoiding long-term, large-scale taking The side effects brought by thyroxine tablets make up for the deficiency of western medicine. Based on clinical and experimental research, we have selected effective prescriptions to develop a variety of proprietary Chinese medicines for the treatment of hypothyroidism, hypothyroidism, and thyroiditis, which not only improve clinical efficacy but also facilitate patients.

Precautions for patients with chronic thyroiditis

1. Eat less and eat more, not overeating. Avoid spicy, tobacco and alcohol.

2, add sufficient water, drink about 2500ml of water a day, avoid excitement drinks such as coffee, strong tea.

3. Appropriate control of high-fiber foods, especially when diarrhea.

4, pay attention to the reasonable mix of nutritional ingredients.

5, fasting kelp, sea fish, jellyfish and other foods containing high iodine. Since iodine is extremely volatile in the air or after being heated, it can be used simply by placing the iodine salt in the air or heating it slightly.

6. Eat foods rich in potassium and calcium.

7. Appropriately control the diet after the disease is alleviated.

Nutritional composition of the main foods of chronic thyroiditis

1. Cereals: carbohydrates and B vitamins

2. Meat and products: high-quality protein, fat, B vitamins

3. Milk and products: various nutritional ingredients except cellulose

4. Eggs and products: high-quality protein, high methionine

5. Beans and products: high-quality protein, low fat

6, vegetables, fruits: rich in vitamins.

Chronic thyroiditis treatment principles

Because Hashimoto's thyroiditis is a chronic disease, once you find that the neck is swollen and the diagnosis is accurate, do not take the risk to remove the thyroid enlargement. Because this is easier for patients with Hashimoto's thyroiditis to enter the hypothyroidism early and need to take thyroid hormone for a long time. To deal with Hashimoto's thyroiditis, the correct method should be: exercise more, eat less iodine-containing food, take regular blood tests and receive ultrasound tracking. Patients who have already been treated with drugs should return regularly to make appropriate drug adjustments. Although Hashimoto's hyperthyroidism has some of the above-mentioned characteristic clinical manifestations, histological examination of Hashimoto's hyperthyroidism is still indispensable. In thyroid biopsy histology, the diagnosis can only be confirmed if there are two histological signs of typical Hashimoto's disease and toxic diffuse goiter. In the same specimen, completely different parts of the two can sometimes exist independently. In most cases, the two overlap. It is usually treated with small doses of antithyroid drugs and appropriate doses of thyroid hormones, and the course of treatment is often longer. Due to low thyroid reserve function, a large amount of antithyroid drugs can easily lead to hypothyroidism. The symptoms of hyperthyroidism can last for many years, and the elderly often develop myxedema. Therefore, surgery and radioactive iodine treatment should not be used for treatment, otherwise permanent hypothyroidism may occur. Another manifestation of Hashimoto's hyperthyroidism is Hashimoto's and transient hyperthyroidism. Hashimoto's disease is an autoimmune thyroid disease. The pathological change is mainly infiltration of lymphocytes in the thyroid tissue. As a result, the thyroid tissue is damaged, often leading to hypothyroidism. However, when the condition of chronic lymphocytic thyroiditis progresses to a certain stage, thyroid follicles are destroyed due to factors such as immune factors. The thyroid hormones stored in the follicles are released into the blood, increasing the concentration of thyroid hormones in the blood circulation and causing hyperthyroidism . This type of hyperthyroidism is often transient. After the metabolism (depletion) of thyroid hormones released into the bloodstream, the symptoms of hyperthyroidism disappear. Treatment is only symptomatic, and antithyroid drugs are generally not used. Radioactive iodine treatment and surgical treatment are prohibited. There are also a few patients who can develop myxedema from Hashimoto's disease and then convert to Graves 'disease, because Hashimoto's disease, Graves' disease, and myxedema are all autoimmune thyroid diseases. The pathogenesis of the three is similar. Mutual transformation, it is currently believed that the three belong to different clinical types of the same disease.

Chronic thyroiditis diagnostic criteria

At present, the diagnostic criteria for CLT have not been unified. In 1975, Fisher proposed five indicators for diagnosis, namely

diffuse thyroid enlargement, tough texture, uneven surface or nodules;

TGAb and TMAb are positive;

elevated blood TSH;

irregular thick or thin thyroid scan;

Positive test of potassium perchlorate excretion.

CLT can be diagnosed in 2 out of 5 cases and confirmed in 4 cases. Generally, as long as it has typical clinical manifestations of CLT in the clinic, serum TGAb and TPOAb positive can be clinically diagnosed as CLT. For patients with atypical clinical manifestations, a high titer of antithyroid antibody is required for diagnosis. If these patients are positive for serum TGAb and TPOAb, they should be given the necessary imaging examinations and diagnosed with thyroxine. If necessary, they should be confirmed by FNAC or frozen section histology.