Hyperthyroidism is hyperthyroidism, which is a very common endocrine disease in clinic. It refers to a series of hypermetabolic syndrome, symptoms of hyperexcitability and ocular symptoms of nervous system, circulatory system, digestive system and cardiovascular system caused by excessive secretion of thyroid hormone or elevated levels of thyroid hormone (T3, T4) in blood for various reasons. Clinically, patients with hyperthyroidism mainly show palpitation, tachycardia, fear of heat, sweating, overeating, emaciation, emaciation, fatigue, irritability, impatience, insomnia, inattention, exophthalmos, trembling hands and tongue, goiter or enlargement, menstrual disorder or even amenorrhea in women, impotence or breast development in men, etc. Goiter is symmetrical, and some patients are asymmetrical. Goiter or enlargement will move up and down with swallowing, and some patients with hyperthyroidism have thyroid nodules. Eye changes caused by hyperthyroidism, one is benign exophthalmos, the patient's eyeball protrudes, his eyes stare or show frightened eyes; The other is malignant exophthalmos, which can be transformed from benign exophthalmos Patients with malignant exophthalmos often have photophobia, tears, diplopia, decreased vision, eye swelling and pain, tingling, foreign body sensation and so on. Because the eyeball is highly prominent, you can't close your eyes, and the conjunctiva and cornea are exposed, causing congestion, edema and corneal ulceration. , even blind. Some patients with hyperthyroidism have no ocular symptoms or the symptoms are not obvious. All the above are typical clinical manifestations of hyperthyroidism, but not every hyperthyroidism patient has all clinical symptoms. Different types of hyperthyroidism have different clinical manifestations.
2. In daily food, kelp, laver, Chinese cabbage, marine fish, shrimp, crab and shellfish are rich in iodine. Excessive iodine is unfavorable to the condition, which is manifested as:
(1) Aggravating hyperthyroidism: Because iodine is the main raw material for making thyroid hormone, taking iodine for a long time will aggravate hyperthyroidism and even cause hyperthyroidism caused by iodine.
(2) It is not good for treatment: eating too much iodine may also harden thyroid tissue, which will lead to the persistence of the disease and affect the treatment of antithyroid drugs. Excessive iodine will prolong the treatment time of hyperthyroidism with thyroid drugs and reduce the cure rate. After excessive iodine supplementation, the cure rate of antithyroid drugs for hyperthyroidism will drop to 20% ~ 35%.
Therefore, patients with hyperthyroidism should avoid eating iodine-containing foods such as kelp, laver and marine fish, and ban iodine-containing Chinese medicines such as seaweed and kelp. Patients should eat non-iodized salt when they eat salt. If iodized salt is used, it should be fried at high temperature for a period of time before eating, so that iodine can evaporate.
3. Patients with hyperthyroidism should pay attention to:
(1) Taboo spicy food: pepper, raw onion, raw garlic;
(2) Taboo seafood: kelp, shrimp, hairtail;
(3) taboo strong tea, coffee, tobacco and alcohol;
(4) Keep calm and prevent fatigue.
Hyperthyroidism is a disease caused by the thyroid gland secreting too much thyroid hormone. This disease is more common in women. Excessive thyroid hormone can cause a series of clinical manifestations, such as fear of heat, hyperhidrosis, hyperhidrosis, emaciation, palpitation, emotional tension and impatience. Most patients with hyperthyroidism have goiter, and the degree of goiter varies from light to heavy. Very few patients with hyperthyroidism do not have goiter. Many patients with hyperthyroidism still have exophthalmos, and the degree of exophthalmos varies from light to heavy. Thyroid function examination showed that the iodine uptake rate of 13 1 increased, and the levels of thyroid hormones (T3, T4) in blood increased significantly. The most common type of hyperthyroidism is toxic diffuse goiter, which accounts for about 80% of all hyperthyroidism patients. Its etiology is mainly related to immune dysfunction and congenital inheritance.
Where is the thyroid gland in the body?
In daily conversation, many people don't know where the thyroid gland is in the body. The thyroid gland is located in the anterior lower part of the neck, followed by the cricoid cartilage of the sixth trachea and the anterior cervical muscle group in front. The human thyroid gland began to appear in the fetal period. After the fetus is born, the thyroid gland develops into two glandular lobes, and the middle part connecting the two glandular lobes is isthmus. In adolescence, the thyroid gland is mature and weighs 15 ~ 30g. Each leaf is 2 ~ 2.5cm wide, 4 ~ 5cm high, and the isthmus is 2cm wide and 2cm high. The thyroid gland of women is slightly larger than that of men. Under normal circumstances, because the thyroid gland is very small and thin, it can neither be seen nor touched in the neck. If you can touch the thyroid gland in the neck, even if you can't see it, it is considered goiter. This degree of swelling is often physiological, especially in female adolescence, which is generally not the result of disease, but sometimes it may be pathological.
What is hyperthyroidism crisis?
If hyperthyroidism is not cured for a long time, a series of complications may occur, such as hyperthyroidism heart disease, hyperthyroidism limb paralysis, hyperthyroidism hypertension, hyperthyroidism diabetes, hyperthyroidism psychosis and so on. Severe cases can lead to hyperthyroidism crisis, and if the rescue is not urgent, it can often endanger life.
Hyperthyroidism crisis is the rapid deterioration of hyperthyroidism, leading to serious metabolic disorder, serious dysfunction of cardiovascular system, digestive system and nervous system, which is often life-threatening. If the diagnosis and rescue measures are not timely, the mortality rate is extremely high. Even if the diagnosis and treatment are timely, about 5 ~ 15% patients are difficult to survive.
The pathogenesis of this disease is not completely clear, and it is often caused by some stress factors when hyperthyroidism is untreated or uncontrolled after treatment. Under stress, the thyroid gland synthesizes a lot of thyroid hormones and releases them into the blood, which makes the original hyperthyroidism condition deteriorate sharply. Stress can obviously enhance the activity of catecholamine and further aggravate the condition.
Can hyperthyroidism patients eat food containing iodine?
Patients with hyperthyroidism should not eat iodine-containing food! The reason for this is the following：
(1) iodine is one of the important raw materials for thyroid hormone synthesis. The content of thyroid hormone in hyperthyroidism patients is higher than that in normal people. If we give iodine-containing food again, the thyroid gland of hyperthyroidism will synthesize more hormones, which will further aggravate the condition.
(2) The thyroid bioavailability of hyperthyroidism patients is significantly higher than that of normal people. Even if a small dose of iodine-containing food is given, the diseased thyroid gland may produce more thyroid hormones than normal, which will aggravate the condition.
(3) After eating too much iodine-containing food, the normal body will excrete excess iodine to avoid producing too much thyroid hormone. However, hyperthyroidism patients have abnormal thyroid function and unbalanced self-protection mechanism. Not only can they not remove excess raw materials, but they will overuse these iodine and synthesize a lot of thyroid hormones, which will make the condition worse.
It can be seen that hyperthyroidism patients should not only supplement iodine-containing foods, but should avoid using any iodine-containing foods and drugs as much as possible. Seafood has the highest iodine content, especially kelp, jellyfish, laver, moss strips and mussels. At the same time, patients with hyperthyroidism should be careful to use iodine, iodine-containing throat tablets, iodine-containing contrast agents and other drugs.
(1) Give adequate carbohydrate and fat. Carbohydrate and fat can save protein, and if the supply is sufficient, protein can play its unique physiological function. Give adequate vitamins and inorganic salts. Vitamins and inorganic salts can regulate physiological functions and improve metabolism, especially vitamin B and vitamin C. Adequate calcium and iron should be given to prevent deficiency.
(2) Appropriately increase animal viscera, fresh green leafy vegetables, or supplement vitamin preparations.
(3) Appropriate control of foods with more cellulose. Hyperthyroidism patients often have diarrhea, and excessive supply of food rich in cellulose will aggravate diarrhea.
(4) Avoid irritating tea, coffee, cigarettes and wine.
What are the Chinese patent medicines for treating hyperthyroidism?
There are many Chinese patent medicines for treating hyperthyroidism, which are the experience of clinicians in treating this disease from different angles. Good results have been achieved in treating hyperthyroidism, and the extracts are as follows:
1. Compound Konka ointment
Composition: Radix Astragali, Radix Codonopsis, Radix Ophiopogonis, Radix Paeoniae Alba and Prunellae Spica each 65,438 05g, Radix Rehmanniae, Radix Salviae Miltiorrhizae and Concha Ostreae each 30g, Perilla frutescens, Fructus Schisandrae Chinensis and Rhizoma Cyperi preparata each 65,438 00g, and Semen Sinapis Albae 6g.
Indications: patients with mild to moderate hyperthyroidism; Hyperthyroidism patients who are allergic to thiourea drugs; Patients with leukopenia cannot use antithyroid drugs; Consolidation therapy after remission of antithyroid drugs.
Usage and dosage: Make the above ointment, each time 10g, three times a day, three months as a course of treatment, and take it for several courses continuously.
Efficacy: After 50 cases were treated, the remission rate of symptoms and signs was 90.9%, the effective rate of basal metabolic rate was 62.5%, and the effective rate of thyroid iodine uptake rate 13 1 iodine rate was 70%. Severe hyperthyroidism combined with antithyroid drugs can reduce the toxic reaction of the latter and shorten the course of treatment. Pharmacology has proved that this recipe can promote phagocytosis of reticuloendothelial system, improve cellular immunity and humoral immunity, promote protein synthesis and energy metabolism, and directly inhibit the synthesis of thyroxine. Zhejiang Journal of Traditional Chinese Medicine; Journal of Zhejiang University of Traditional Chinese Medicine; (8)∶360〕
2. Compound Jiakangning Tablets
Ingredients: Prunella vulgaris, Carapax Trionycis preparata, raw oysters, Scrophularia, Pseudostellaria heterophylla, etc.
Indications: Mainly used for hyperthyroidism patients with hyperactivity of liver yang and deficiency of both qi and yin.
Usage and dosage: the above materials are processed into tablets, each time 10 tablets, three times a day, 1 month is 1 course of treatment.
Efficacy: 30 patients with simplified hyperthyroidism index scheme T 1 > 10 were treated with this tablet, and the longest course of treatment was 6 courses. Clinical cure 1 1 case, marked effect 14 cases, improvement in 4 cases, ineffectiveness 1 case (other Chinese and western medicines are stopped when taking this medicine). Experiments show that this recipe can reduce the energy metabolism and TT3 concentration in blood of hyperthyroidism rabbits, and its pharmacological mechanism may be: on the one hand, it weakens the reaction of thyroid hormone target organs and tissues to thyroxine, on the other hand, it accelerates the degradation of thyroid hormone that has entered the blood circulation. And most of them have immunomodulatory effect, so the two-way immunomodulatory effect of this traditional Chinese medicine compound can be used to rebuild the stability of human immune system. Chen; Chen; Chen; (3)∶ 147〕。
3 Kangjia pills
Composition: dried tangerine peel100g, Pinellia ternata150g, Poria cocos150g, seaweed150g, kelp150g, selfheal 200g, and roasted oyster150g.
Indications: Tumors caused by internal injuries, anxiety, anger, etc.
Usage and dosage: the medicine * * * is fine powder, and honey is pill, each pill weighs 65438±05g, twice a day, with 65438 0 pills each time.
Efficacy: This pill was used to treat hyperthyroidism 125 cases, 65 cases were cured, 24 cases were markedly effective, 23 cases were improved, and 3 cases were ineffective 13 cases. The cured patients ate at least 90 capsules, and the most was 180 capsules.
Drug research shows that seaweed, kelp, Dioscorea zingiberensis and Prunella vulgaris in this prescription are all Chinese medicines containing iodine, and iodine is an element for synthesizing thyroxine (TH). Within a certain dose limit, the amount of TH synthesis increases with the increase of iodine dose. If it is used beyond the limit, it will cause the opposite result-inhibiting the synthesis of thyroxine. Pharmacological dose of iodine not only inhibits the synthesis of thyroxine, but also inhibits the release of thyroxine. After iodine treatment, the synthesis and release of TH were inhibited, the level of TH in blood decreased rapidly, and the symptoms of hyperthyroidism began to relieve rapidly. [Huang Taikang. Handbook of TCM Prescriptions for Difficult Diseases] China Medical Science and Technology Press 1997.
4 Kunming Haitang tablets
Usage and dosage: 20 cases in group A took 6 tablets of this product every day (equivalent to 2.6 grams of crude drug); Group B (36 cases) took 65438±05mg of tabazole daily. After 4 ~ 8 weeks of treatment, 9 cases in group A/KLOC-0 were relieved (clinical symptoms were relieved, heart rate was less than 90 beats/min, serum T3 and T4 were reduced to normal), and all cases in group B were relieved. After treatment, the serum T3 and T4, anti-thyroglobulin antibody and anti-thyroid microparticle antibody in the two groups decreased significantly compared with those before treatment, and there was a significant difference in statistical treatment (P < 0.05 ~ 0.0 1). Journal of traditional chinese medicine, China; (8)∶36〕
5 Jiakangling tablets
Ingredients: Prunella vulgaris, Eclipta prostrata, Salvia miltiorrhiza, Chinese yam, calcined keel, calcined oyster, etc. Made into tablets.
Indications: hyperthyroidism with yin deficiency and hyperactivity of yang.
Usage and dosage: The treatment group took 7 tablets of this product, three times a day, while the control group took 2 tablets of tabazole (10 mg), three times a day, and took 2 tablets and 7 tablets of placebo respectively. 1 month is a course of treatment.
Efficacy: the treatment group 150 cases, the control group 75 cases. Results In the two groups, 26 cases were cured, marked 14 cases, 89 cases were effective, 23 cases were effective, 7 cases were ineffective 12 cases were ineffective. The total effective rates were 92% and 89.3% respectively. There were significant differences in heart rate, basal metabolism, TT3 and TT4 before and after treatment (P < 0.0 1). [Yang Chunhua. Journal of Hunan College of Traditional Chinese Medicine1997; (4)∶5~6〕
Treatment of hyperthyroidism
Hyperthyroidism is a common endocrine disease, which is caused by excessive thyroxine. Treatment methods include drugs, surgery, radioactive iodine, etc. Among them, drug therapy is the most commonly used. In order to reduce recurrence and achieve better results, the following points should be paid attention to in treatment.
First of all, we should understand the side effects of thyroid drugs (tapazole or propylthiouracil), such as leukopenia, agranulocytosis, skin itching (or rash), and a few liver damage. Among them, agranulocytosis is the most important, so the white blood cell count should be checked regularly. Those who decrease should use drugs that increase white blood cells, such as Buxuesheng and Glycol, and stop taking drugs when necessary.
In daily life, many people mistakenly think that they should eat more kelp after suffering from hyperthyroidism. In fact, doing so interferes with and is not conducive to the treatment of hyperthyroidism. Proper treatment should avoid iodine-containing foods such as kelp, laver, cabbage, seafood, fish and shrimp. Use salt instead of iodized salt, or put it in early when cooking.
During the treatment, patients should go to the hospital regularly to check thyroid function, so that doctors can adjust the dose in time according to the clinical and laboratory examination and prevent drug-induced hypothyroidism. Some patients stop taking medicine after their symptoms improve, which is easy to relapse. Therefore, they can't stop taking medicine as soon as they get better, and they need to maintain the dose for a long time, and the course of treatment is about two years.
Drug treatment should combine traditional Chinese and western medicine. Traditional Chinese medicine can regulate the immune state of the body and reduce recurrence.
Overwork and mental stress are the inducement of hyperthyroidism recurrence, so reasonable living arrangement, optimistic mood, correct diet and drug treatment are the keys to hyperthyroidism treatment.