[Ginger-partition moxibustion combined with glucocorticoid for thyreoitis at subacute stage: a randomizd controlled trial].

OBJECTIVE: To compare the clinical effects between ginger-partition moxibustion combined with glucocorticoid and simple oral glucocorticoid for thyreoitis at subacute stage. METHODS: Eighty-one patients were randomly divided into an observation group (41 cases) and a control group (40 cases). In the observation group, ginger-partition moxibustion and hormone were applied. Moxa cones were used at local ashi points, Zusanli (ST 36), Guanyuan (CV 4) and Qihai (CV 6), six cones every point, once every other day and three times a week. Besides, 24 mg methylprednisolone tablets were adopted orally every day, and in two weeks the dose was 16 mg/d, in four weeks 8 mg/d, in six weeks 4 mg/d; all the patients were observed for 8 week. In the control group, simple methylprednisolone was prescribed orally, and the dose, the usage and treatment time were the same as those in the observation group. Erythrocyte sedimentation rate (ESR), triiodothyronine (T3), thyroxin (T4) and ultra-sensitive thyroid stimulating hormone (TSH) before and after treatment were observed in the two groups, as well as fever, the pain of thyroid gland, the regression time of swelling and adverse reaction. RESULTS: The time of thyroid gland pain relieved of the observation group was earlier than that of the control group [(3.07 ± 0.78) days vs (3.62 ± 0.92) days, P < 0.05]. After treatment, T3, T4 and ESR were declined apparently (all P < 0.01), and TSH was obviously increased in the two groups (both P < 0.01). After 2-week treatment, ESR in the observation group was lower than that in the control group (P < 0.05). After 4-week treatment, T3, T4, TSH and ESR in the observation group were better than those in the control group (all P < 0.05). After 8 weeks, all indices in the observation group were superior to those in the control group, without statistical significance between the two groups (all P > 0.05). The effects of the observation group in 2 weeks, 4 weeks and 8 weeks were better than those in the control group (all P < 0.05). The cured course was shorter in the observation group than that in the control group (P < 0.05). The adverse reaction rate in the observation group was lower than that in the control group [4.9% (2/41) vs 22.5% (9/40), P < 0.05]. Three months later after treatment, the cured patients were followed. There was no recrudescence in the observation group and three patients caught the disease again in the control group, but there was no statistical significance between the two groups (P > 0.05). CONCLUSION: Ginger-partition moxibustion combined with glucocorticoid achieves better effect than simple oral glucocorticoid for thyreoitis at subacute stage, and the adverse reaction is less, which presents the clinical advantages of the integration of Chinese and western medicine.

Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline.

OBJECTIVE: The aim was to update the guidelines for the management of thyroid dysfunction during pregnancy and postpartum published previously in 2007. A summary of changes between the 2007 and 2012 version is identified in the Supplemental Data (published on The Endocrine Society's Journals Online web site at http://jcem.endojournals.org). EVIDENCE: This evidence-based guideline was developed according to the U.S. Preventive Service Task Force, grading items level A, B, C, D, or I, on the basis of the strength of evidence and magnitude of net benefit (benefits minus harms) as well as the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. CONSENSUS PROCESS: The guideline was developed through a series of e-mails, conference calls, and one face-to-face meeting. An initial draft was prepared by the Task Force, with the help of a medical writer, and reviewed and commented on by members of The Endocrine Society, Asia and Oceania Thyroid Association, and the Latin American Thyroid Society. A second draft was reviewed and approved by The Endocrine Society Council. At each stage of review, the Task Force received written comments and incorporated substantive changes. CONCLUSIONS: Practice guidelines are presented for diagnosis and treatment of patients with thyroid-related medical issues just before and during pregnancy and in the postpartum interval. These include evidence-based approaches to assessing the cause of the condition, treating it, and managing hypothyroidism, hyperthyroidism, gestational hyperthyroidism, thyroid autoimmunity, thyroid tumors, iodine nutrition, postpartum thyroiditis, and screening for thyroid disease. Indications and side effects of therapeutic agents used in treatment are also presented.

Tratamento homeopático de nódulos tireoidianos complicados: a propósito de dois casos / Homeopathic treatment of complex thyroid nodules: two cases with to respect

Apresenta-se o resultado do tratamento homeopático de dois pacientes portadores de nódulos tireoidianos de grande tamanho, com complicações decorrentes do tamanho e da história natural dos tumores. Ambos os pacientes, um do sexo masculino com bócio nodular com projeção retro-esternal, e outra de sexo feminino com um nódulo com hemorragia intranodular, por motivos pessoais se manifestaram contrários às opções de tratamento convencional. O tratamento homeopático com diluições baixas e repetidas induziu rápidas e significativas melhoras, sugerindo que o mesmo pode ser considerado uma terapêutica complementária, eficaz nesta patologia. Esses resultados preliminares sugerem também que outros estudos devem ser realizados em maior escala a fim de verificar a eficácia do tratamento homeopático nesta patologia.(AU)

This paper reports the homeopathic treatment of two patients suffering from large size thyroid nodes with complications due to their size and the natural history of these tumors. Both patients, a male with nodular goiter extending behind the sternum, and a female with intranodular hemorrhage opposed conventional treatment on personal grounds. Homeopathic treatment using low and repeated dilutions elicited quick and significant improvements, suggesting that it can be rated as a complementary therapy effective in this disease. These preliminary results also suggest that further and large scale studies need to be performed in order to verify the efficacy of homeopathic treatment in thyroid nodes. (AU)

Tratamento homeopático de nódulos tireoidianos complicados: a propósito de dois casos / Homeopathic treatment of complex thyroid nodules: two cases with to respect

Apresenta-se o resultado do tratamento homeopático de dois pacientes portadores de nódulos tireoidianos de grande tamanho, com complicações decorrentes do tamanho e da história natural dos tumores. Ambos os pacientes, um do sexo masculino com bócio nodular com projeção retro-esternal, e outra de sexo feminino com um nódulo com hemorragia intranodular, por motivos pessoais se manifestaram contrários às opções de tratamento convencional. O tratamento homeopático com diluições baixas e repetidas induziu rápidas e significativas melhoras, sugerindo que o mesmo pode ser considerado uma terapêutica complementária, eficaz nesta patologia. Esses resultados preliminares sugerem também que outros estudos devem ser realizados em maior escala a fim de verificar a eficácia do tratamento homeopático nesta patologia.

This paper reports the homeopathic treatment of two patients suffering from large size thyroid nodes with complications due to their size and the natural history of these tumors. Both patients, a male with nodular goiter extending behind the sternum, and a female with intranodular hemorrhage opposed conventional treatment on personal grounds. Homeopathic treatment using low and repeated dilutions elicited quick and significant improvements, suggesting that it can be rated as a complementary therapy effective in this disease. These preliminary results also suggest that further and large scale studies need to be performed in order to verify the efficacy of homeopathic treatment in thyroid nodes.