从肝脾论治桥本甲状腺炎的思路探析  

Treating HT Based on Regulating Liver and Spleen

作　　者：王冰梅[1] 张子默 李敬孝[1] 岑岚风 甘宇 聂双莲[1] WANG Bingmei;ZHANG Zimo;LI Jingxiao;CEN Lanfeng;GAN Yu;NIE Shuanglian(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China;Heilongjiang University of Chinese Medicine, Harbin 150040, China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001, China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040 [3]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001

出　　处：《中医药学报》2022年第6期9-11,共3页Acta Chinese Medicine and Pharmacology

基　　金：黑龙江省中医药管理局省级名中医专家传承工作室建设项目(201906);国家中医药管理局第六批全国老中医药专家学术经验继承人项目(国中医药人教发〔2017〕29号)。

摘　　要：桥本甲状腺炎是自身免疫性甲状腺炎的经典类型,发病机制多样复杂,临床发病率也呈逐年上涨趋势。该病的发病与情志因素、饮食水土、体质等因素息息相关,病位涉及肝脾肾,病机实则为本虚标实。本病病变的发生基于情志内伤,肝失疏泄,病变之初,多属肝旺,随病变的发生发展,累及脾脏。本文着重强调切准病机因素,病证结合,早期清肝泻火,中后期益气健脾以扶正,提出了“肝脾同调”的理论之法。从“肝脾论治”是中医学对肝脾两脏维持机体稳定和扶正御邪的重要诊治方向。基于“肝脾同调”的理论探讨“肝脾”在桥本甲状腺炎疾病发展过程中的重要地位,为临床治疗此类疾病提供了新的思路。Hashimoto’s thyroiditis(HT)is a classic type of autoimmune thyroid,the pathogenesis of HT is complex and its clinical morbidity is rising year by year.The onset of the disease is closely related to emotional factors,diet habit,living environment and body constitution.The locations of the disease involve Liver,Spleen and Kidney,and the pathogenesis is deficient root and excessive manifestation.The changes of the disease is based on internal emotional injuries and Liver failing in free coursing.At the beginning,it is more due to Liver hyperactivity,with the occurrence and development of the lesions,Spleen is involved as well.This study emphasized clarifying the pathogenesis and combining disease and syndrome,and it put forward the treatment principle of simultaneously treating Liver and Spleen according to purging Liver-fire in the early stage and supplementing Spleen-Qi in the middle stage.Simultaneously treating Liver and Spleen are the main guidance to maintain body stability and supporting healthy-Qi and removing evil-Qi.This study discussed the important role of Liver and Spleen in the process of HT,and provided reference for the clinical treatment of the disease.

关 键 词：桥本甲状腺炎 瘿病 肝脾论治 肝脾同调 病因病机 

分 类 号：R223.1[医药卫生—中医基础理论]