Hashimoto's thyroiditis (HT) is an autoimmune disease, and a major cause of hypothyroidism. Due to its insidious nature, non-presence of clear clinical symptoms, there is often a delay in getting a diagnosis for HT, which leads to irreversible damage. Therefore, early screening and improving diagnostic accuracy are essential to the treatment of HT. There are few studies on the application of infrared thermal imaging technology as an auxiliary diagnostic tool for HT.

To explore the features of metabolic calorific values measured by infrared thermal imaging in female adults with HT.

Participants were recruited from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from April 2019 to June 2021, including 100 adult gynecological outpatients with HT, and 100 healthy, adult female physical examinees. Both groups completed the Classification and Determination of Constitution in TCM (ZYYXH/T157-2009) for assessing the constitution in TCM. Thyroid function test was performed to understand levels of thyroid function parameters〔thyroglobulin antibody (TGAb) , thyroid peroxidase antibody (TPOAb) , thyroid-stimulating hormone (TSH) , free triiodothyronine (FT₃) , free thyroxine (FT₄) 〕. Full body thermography using infrared thermal imaging was implemented to examine the calorific values of the left and right lobes of the thyroid gland, the uterus, the Shenque acupoint and the Governor vessel. The aforementioned parameters were compared between HT patients and physical examinees to identify intergroup differences. The calorific values of thyroid left and right lobes, the uterus, the Shenque acupoint and the Governor vessel were compared across HT patients with 9 types of constitution in TCM, and the associations of them with thyroid function parameters were explored, then their associations with infertility in HT were evaluated using binary logistic regression analysis.

The top 4 types of constitution in TCM in HT patients were yang-deficiency, qi-stagnation, damp-heat, and phlegm-dampness. The calorific values of Shenque acupoint and the Governor vessel varied significantly across HT patients by types of constitution (n=9) in TCM (P<0.05) . Compared with the control group, the levels of TGAb, TPOAb and TSH in HT group increased (P<0.05) . There was no significant difference in FT₃ and FT₄ levels between the two groups (P>0.05) . HT patients had higher calorific values of thyroid left and right lobes and lower calorific values of the uterus, Shenque acupoint and the Governor vessel than physical examinees (P<0.05) . In the HT group, the calorific value of the left or right lobe of the thyroid gland was positively correlated with TGAb (r_s=0.260, 0.198, P<0.05) , and the calorific value of the uterus was negatively correlated with TSH (r_s=-0.313, P<0.05) . The calorific values of the uterus〔OR=0.413, 95%CI (0.180, 0.945) 〕, the Governor vessel〔OR=0.270, 95%CI (0.075, 0.971) 〕, and the Shenque acupoint〔OR=0.264, 95%CI (0.073, 0.954) 〕were associated with infertility in HT (P<0.05) .

In adult female HT patients, the most common four types of constitution in TCM were yang-deficiency, qi-stagnation, damp-heat, and phlegm-dampness. The metabolic calorific values measured by infrared thermal imaging were featured by higher values of thyroid left and right lobes, and lower values of the uterus, Shenque acupoint and the Governor vessel, which may be new theoretical evidence obtained from clinical practice explaining infertility in HT. Furthermore, the calorific values of thyroid left and right lobes could be used as parameters for early screening or identifying HT. So infrared thermal imaging could be used as an auxiliary diagnostic tool to improve the diagnostic efficiency of HT.

桥本甲状腺炎（HT）是一种常见的自身免疫性疾病，是引起甲状腺功能减退的主要原因之一。由于该病起病隐匿，无明显的临床症状，患者常因诊断不及时而延误治疗，造成不可逆的损伤，因此早期筛查及提高诊断效能对HT的治疗具有重要意义，但目前以红外热成像技术作为HT辅助诊断工具的研究较少。

探索女性HT红外热成像人体代谢热值特点。

选择2019年4月至2021年6月在成都中医药大学附属医院妇科门诊就诊的HT女性患者100例作为HT组，选择同期体检健康的女性100例作为对照组。两组受试者均填写《中医体质分类与判定（ZYYXH/T157-2009）》调查问卷，检测甲状腺相关指标〔甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）、促甲状腺素（TSH）、游离三碘甲状腺原氨酸（FT₃）、游离甲状腺素（FT₄）〕，进行红外热成像全身扫描（测量甲状腺左叶和右叶、子宫、神阙及督脉区位热值）。比较两组受试者中医体质、甲状腺相关指标及各区位热值差异性；分析HT组9种中医体质患者的5个区位热值差异性，以及5个区位热值与甲状腺相关指标的相关性；同时采用多因素Logistic回归分析各区位热值与HT合并不孕症的关系。

HT患者偏颇体质分布由多至少依次为阳虚质、气郁质、湿热质及痰湿质，9种中医体质间的督脉与神阙区位热值比较，差异有统计学意义（P<0.05）；与对照组相比较，HT组TGAb、TPOAb水平及TSH水平升高（P<0.05）。两组受试者FT₃、FT₄水平比较，差异均无统计学意义（P>0.05）；HT组甲状腺左、右叶区位热值均高于对照组，其子宫、督脉及神阙区位热值均低于对照组（P<0.05）。HT组甲状腺左、右叶区位热值与TGAb呈正相关（r_s=0.260，r_s=0.198，P<0.05），子宫区位热值与TSH呈负相关（r_s=-0.313，P<0.05）。子宫〔OR=0.413，95%CI（0.180，0.945）〕、督脉〔OR=0.270，95%CI（0.075，0.971）〕、神阙〔OR=0.264，95%CI（0.073，0.954）〕区位热值是HT合并不孕症的影响因素（P<0.05）。

HT患者好发的中医体质为阳虚质、气郁质、湿热质及痰湿质，其代谢热值变化具有甲状腺左、右叶区位热值偏高，子宫、督脉及神阙区位热值偏低的特点，该特点也为HT引发不孕症提供了新的临床理论依据。同时甲状腺左、右叶区位热值可作为HT早期诊断及筛查的指标之一，因此可将红外热成像技术作为辅助诊断工具以提高HT的诊断效能。