近5年毒性弥漫性甲状腺肿中医病机及辨证论治研究概述  

Research overview on TCM pathogenesis and treatment based on syndrome differentiation of Graves’disease in recent five years

作　　者：石霞 朱晓云[1] 刘喜明[1] SHI Xia;ZHU Xiaoyun;LIU Ximing(Guang'anmenHospital,China Academy of Chinese Medicine Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院内分泌科,北京100053 [2]北京中医药大学

出　　处：《环球中医药》2020年第6期1119-1124,共6页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(81774293、81373593)。

摘　　要：毒性弥漫性甲状腺肿(Graves disease,GD)根据其临床表现可归属于中医“瘿气”“瘿病”范畴,中医治疗GD较西医具有安全性高、不易反复等优势。本文通过查阅、归纳、分析中医古籍及近5年相关文献,总结了GD中医病机及辨证论治方法,认为GD病性多属虚实夹杂,治疗多从脏腑辨证、气血津液辨证、三焦及六经辨证出发,围绕其肝郁气滞、肝火旺盛、血瘀痰凝、气阴两虚四大病机进行分型,或根据病程将其分为二或三期,以疏肝理气、益气养阴为主要治法,将化痰散瘀之法贯穿疾病始终,以达标本同治之效,亦有医家妙用古方,或巧用经验方、自拟方,均取得满意疗效。同时指出当前研究所存在的不足并提出展望,以期进一步提高中医对GD辨证论治的准确性,提升中医药治疗GD的临床疗效。Graves’disease(GD)can be classified into the category of goiter qi and goiter disease of TCM.Compared with western medicine,according to its clinical manifestations.Compared with western medicine,treating GD with TCM has the advantages of high safety and not easy to repeat.In this paper,The ancient books of TCM and the related literatures in recent five years were reviewed,summarized and analyzed,and the TCM pathogenesis and treatment based on syndrome differentiation of GD were summarized.It is believed that the disease’s quality of GD is intermingled deficiency and excess.The treatment of it mainly starts from the syndrome differentiation of zang-fu viscera,syndrome differentiation of qi-blood and fluid,syndrome differentiation of triple energizer and syndrome differentiation of six channel.The disease were divided into different TCM syndrome types based on the four pathogenesis of liver depression and qi stagnation,liver fire exuberance,blood stasis and phlegm coagulation,deficiency of both qi and yin.It was divided into two or three stages based on course of disease.The dispersing liver and regulating qi method and benefiting qi and nourishing yin method are main treatment methods.The method of resolving phlegm and dispersing blood stasis was used throughout the disease,to achieve the effect of treating symptoms and pathogenesis at the same time.Also doctors,who used the ancient prescriptions flexibly or used empirical formula and Chinese herb on our own cleverly,all has obtained the satisfactory curative effect.At the same time,it points out the shortcomings of the current research and puts forward the prospect,so as to further improve the accuracy of TCM in the treatment of GD based on syndrome differentiation and improve the clinical efficacy of TCM in the treatment of GD.

关 键 词：毒性弥漫性甲状腺肿 甲状腺功能亢进症 中医病机 辨证论治 综述 

分 类 号：R581[医药卫生—内分泌]