Thyroid hormone promotes metabolism and redox reaction. High metabolism requires the body to eat more. Gastrointestinal activity is enhanced, and the frequency of defecation is increased; Although eating increased, the oxidation reaction increased, the energy consumption of the body increased, and the patient showed weight loss; The increase of heat production is manifested as fear of heat and sweating, and some patients have low fever; The increase of thyroid hormone stimulates sympathetic nerve excitement, and its clinical manifestations are palpitation, tachycardia, insomnia, emotional irritability and even anxiety. There are three ways to treat hyperthyroidism: antithyroid drug therapy, radioactive iodine therapy and surgical treatment. There are two kinds of antithyroid drugs-imidazole and pyrithione, and the representative drugs are methimazole (also known as "tabazole") and propylthiouracil (also known as "propylpyrimidine"). Drug therapy is suitable for hyperthyroidism pregnant women, children and patients with mild goiter. General treatment takes 65,438+0 ~ 2 years, and the dosage of drugs should be increased or decreased according to the needs of thyroid function. Drug therapy has some side effects, including neutropenia, drug allergy, liver function damage, joint pain and vasculitis. In the initial stage of drug treatment, it is necessary to closely monitor the side effects of drugs, especially agranulocytosis. It is necessary to remind patients that once fever and/or sore throat occur, it is necessary to check granulocytes immediately to determine whether there is agranulocytosis. Stop taking the medicine immediately. An emergency. Another disadvantage of drug therapy is the high recurrence rate after drug withdrawal. Radioiodine therapy and surgical treatment are destructive treatments, and hyperthyroidism is not easy to recur. Radioiodine is suitable for patients with moderate goiter or hyperthyroidism recurrence. Doctors calculate the radiation dose required by each patient according to the uptake rate of radioactive iodine by the patient's thyroid. Radioactive iodine is an absolute contraindication for pregnant women and lactating women. Due to the delayed effect of radioactive iodine, the incidence of hypothyroidism is 3% ~ 5% every year with the time of follow-up. Radioiodine therapy is not suitable for hyperthyroidism patients with thyroid ophthalmopathy, because the ophthalmopathy may be aggravated after treatment.

Surgical treatment is suitable for those with obvious goiter, or those with high suspicion of thyroid malignant tumor, or those with dyspnea caused by goiter pressing the trachea. Before operation, drugs should be used to control thyroid function in the normal range, and oral compound iodine solution should be taken for preoperative preparation. At present, there are three most commonly used treatment methods for hyperthyroidism, and each method has its own advantages and disadvantages.

The first is medication, which is what we often call antithyroid drugs. The commonly used drugs are imidazoles and pyrithiones, and the representative drugs are methimazole, tabazole and propylthiouracil. Drug treatment takes a long time, at least one and a half years, or even two to three years. Generally speaking, the longer the treatment time, the lower the recurrence rate.

The second commonly used method is radioactive iodine 13 1 therapy. The advantage of this method is that it is simple and fast. Basically, nail work can basically return to normal in three months, but the most important adverse reaction is likely to appear hypothyroidism. According to our clinical statistics, the incidence of cumulative hypothyroidism can be as high as 40% or even higher after about 5 ~ 10 years of treatment with iodine 13 1. If this permanent hypothyroidism occurs, you may need to use Eupatorium adenophorum for life. Radioactive iodine 13 1 is suitable for patients with moderate goiter or hyperthyroidism recurrence, but it is absolutely contraindicated for pregnant women and lactating women. Another method is surgical resection and partial thyroidectomy. We call it subtotal thyroidectomy. Surgical treatment is often suitable for those cases where goiter is particularly obvious, or thyroid malignant tumor is highly suspected, or goiter has compressed the trachea and has compression symptoms. The postoperative recurrence rate may also reach 8%, and it will also cause some adverse reactions, such as parathyroid injury.