从“木郁达之”论治甲状腺结节  被引量:23

Treating thyroid nodules from‘facilitating the wood stagnation'

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作  者:杜立娟[1] 谈钰濛 王凡[2] 逄冰[1] 倪青[1] DU Li-juan;TAN Yu-meng;WANG Fan;PANG Bing;NI Qing(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beiung 100053,China;Southem District of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102600,China)

机构地区:[1]中国中医科学院广安门医院,北京100053 [2]中国中医科学院广安门医院南区,北京102600

出  处:《中华中医药杂志》2021年第3期1504-1507,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基  金:北京市科技计划课题(No.Z121107001012010)

摘  要:甲状腺结节属于中医"瘿病""瘿瘤"的范畴,其病机为肝失条达,最终导致气、痰、瘀壅结颈前。其病位主要在肝。患者初起多肝脏实病,多以肝气郁结、肝郁血瘀火、肝郁化火为主,后期多以虚实夹杂多见,可见肝血虚、肝阴虚、肝肾阴虚等。"木郁达之"首见于《黄帝内经》,所谓"木郁"即是木气郁结,从而形成异常的气候变化,进而影响人体发生一系列相关疾病的过程,达之,即使之条达,可分为实则泻之和虚则补之。因此,结合《黄帝内经》及临床实践,对甲状腺结节的治疗应从"治肝"入手,根据病情不同时期的证候选择疏理肝气、疏肝化火、疏肝通络、养血柔肝、养阴敛肝、滋补肝肾等方法。Thyroid nodules belongs to the category of ’Ying bing’ ’Ying liu’ in traditional Chinese medicine. The pathogenesis of thyroid nodules is the disorder of the liver, which eventually leads to the congestion of qi, phlegm and blood stasis. The disease position is mainly in the liver. At the beginning, patients mostly are excess, such as the syndromes with liver qi stagnation, qi stagnation and blood stasis, qi stagnation and fire dissipation. In the later period, patients are intermingled deficiency and excess, such as the syndromes with the liver blood deficiency, liver yin deficiency, liver and kidney yin deficiency, etc. ’Facilitating the wood stagnation’ is first seen in Huangdi Neijing. The so-called ’Muyu’ is qi of wood stagnation, which forms abnormal climate changes, which in turn affects the process of a series of related diseases in the human body. The ’Dazhi’ means making it smooth, which can be divided into tonifying deficiency and reducing excess. So, the treatment for thyroid nodules should start from ’treating the liver’ combining Huangdi Neijing and clinical experience, according to the syndrome of different periods of the disease, choose the method of resolving liver qi, soothing liver and dissipating fire, liver-soothing and qi-regulating, liver-soothing and fire-removing, liversoothing and collateral-dredging, nourishing blood and softening liver, nourishing yin and astringent liver, nourishing the liver and kidney, etc.

关 键 词:甲状腺结节 肝失条达 治肝法 木郁达之 黄帝内经 思路 方法 

分 类 号:R259[医药卫生—中西医结合]

 

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