张曾譻从 “精明失养”论治桥本氏甲状腺炎经验  

Zhang Zengying"Jing Ming Shi Yang"treatment experience in hashimoto′s thyroiditis

作　　者：张铎 张曾譻[2] Zhang Duo;Zhang Zengying(Tianjin Academy of Traditional Chinese Medicine Encephalopathy Department-2,Tianjin 300120;Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital Zhang Zengying Studio,Tianjin 300120)

机构地区：[1]天津市中医药研究院脑病2科,天津300120 [2]天津市中医药研究院附属医院张曾譻工作室,天津300120

出　　处：《山西中医药大学学报》2020年第6期421-424,432,共5页Journal of Shanxi University of Chinese Medicine

基　　金：第六批全国老中医药专家学术经验继承工作项目(国中医药人教发[2017]29号)。

摘　　要：近年来,桥本氏甲状腺炎的发病率呈上升趋势,具有明显甲状腺功能障碍的占0.1%~2%,而亚临床功能障碍的达到10%~15%。女性发病率是男性的5~10倍,并且随着年龄的增长而增加。但是桥本甲状腺炎的发病机制仍不完全清楚,目前尚无针对性的治疗方法,仅在甲状腺功能异常时采取对症的抗甲状腺或激素替代治疗,并需终身服药。张曾譻教授发挥中医学优势,提出“精明失养”是其根本,“禀赋不足,七情内扰”是致病之因,“气虚血滞,心脾阳虚”是贯穿之机,“肝肾阴虚、水火不济”是阶段之变,并由此衍生出“健脑宁心”治疗大法,主张从“脑”论治,以打破“脏腑相干”的恶性循环。用药方面,尤重“通络”以健“脑府”,在长期的临床实践中取得良好疗效。The incidence of Hashimoto′s thyroiditis is rising in recent years.The patients with significant thyroid dysfunction make up 0.1 to 0.2 percent of the population,while with subclinical dysfunction hit 10 to 15 percent.The incidence of Hashimoto′s thyroiditisis is 5 to 10 times higher in women than in men,which increases with age.However,the pathogenesis of Hashimoto′s thyroiditis remains unclear.There is no effective treatment for the disease currently,except symptomatic support therapy and hormone replacement therapy,and both of treatments require patients to take medication for life.Professor Zhang Zengying put forward that Jing Ming failed to foster is the root,Constitution of Deficiency and seven emotions are the cause of the disease,qi-deficiency and blood-stasis as well as heart-spleen yang deficiency are the main mechanism,and liver-kidney Yin vacuity along with water-fire imbalance are the stage change.The treatment of nourishing the brain and heart is established based on the above theory.Professor Zhang suggested that the disease is supposed to be cured based on brain to break the vicious circle of interference among the Viscera.In terms of drug use,Professor Zhang attaches great importance to dredging collaterals and invigorating the brain,so as to achieve good curative effect in long-term clinical practice.

关 键 词：桥本氏甲状腺炎 精明失养 健脑宁心 

分 类 号：R249[医药卫生—中医临床基础] R259[医药卫生—中医学]