论“火郁发之”在亚急性甲状腺炎中的应用  

Discussion on the application of’dispersing therapy of fire stagnation’in subacute thyroiditis

作　　者：周静鑫[1] 苗桂珍 鲁轶臻 刘化平 孙威帅 徐皓 曹柏龙[1] 刘铜华[2] 吴丽丽 ZHOU Jing-xin;MIAO Gui-zhen;LU Yi-zhen;LIU Hua-ping;SUN Wei-shuai;XU Hao;CAO Bai-long;LIU Tong-hua;WU Li-li(Tongzhou Branch of Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101121,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学东直门医院通州院区,北京101121 [2]北京中医药大学,北京100029 [3]北京中医药大学中医学院,北京100029

出　　处：《中华中医药杂志》2020年第9期4699-4701,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中医药防治慢性病国际合作基地(No.GZYYGJ2019034)。

摘　　要：亚急性甲状腺炎是以短暂疼痛、破坏性甲状腺组织损伤伴见全身炎症反应为特征的自限性甲状腺疼痛疾病,西医以非甾体消炎药、糖皮质激素治疗,虽快速缓解疼痛及减轻炎症,但不能缩短病程及改善预后,且具有不良反应。亚急性甲状腺炎属中医"瘿病"范畴,结合症状、发病特点辨为"火郁"证。"火郁发之"最早见于《黄帝内经·素问》,是言阳热结聚不散,怫郁而生,当因其势而解之、散之、升之、扬之谓为发之。亚急性甲状腺炎是因天空阴霾、地失蔭厚,起居生活不节,情志内伤,卫外不固,感受外邪,气机郁闭,火热炽盛,蕴结肝脉颈前而发,当治以"火郁发之",外应天地自然,内畅情志,调达气机升降出入,宣散三焦郁热,通行气血以冲和,则郁火自消病解。Subacute thyroiditis is a self-limiting thyroid pain disease characterized by transient pain,destructive thyroid tissue damage and systemic inflammatory response.Non-steroidal anti-inflammatory drugs and glucocorticoids are used to relieve pain and relieve inflammation quickly,but they can not shorten the course of the disease and improve the prognosis with side effects.Subacute thyroiditis belongs to the category of‘Ying’disease in traditional Chinese medicine.It is differentiated as fire stagnation with the symptoms and the characteristics of the disease.The dispersing therapy of fire stagnation was first seen in Huangdi Neijing·Suwen.It is the aggregation of heat,which is treated by dispersing including solving,scattering,ascending,and raising.Subacute thyroiditis is caused by the haze and dirty of the sky,the loss of the ground,the irregulation of living,the emotional internal changes,and the external evils,expressing the flaming heat around the neck of liver channel.It should be treated via dispersing fire stagnation,in the corresponding natural enviroment,dealing with the emotion,followed by adjusting qi to move up and down,dispering the Sanjiao stagnation,promoting the qi and blood,and then the fire will eliminate in the disease.

关 键 词：亚急性甲状腺炎 火郁发之 小柴胡汤 升降散 

分 类 号：R259[医药卫生—中西医结合]