调肝法治疗甲状腺功能减退症伴贫血  

Treating hypothyroidism with anemia by the liver regulating method

作　　者：王晓涵 张欣[1] 李光善 WANG Xiaohan

机构地区：[1]山东中医药大学,山东济南250300 [2]青岛市中医医院,山东青岛266000

出　　处：《中医临床研究》2023年第8期91-94,共4页Clinical Journal Of Chinese Medicine

摘　　要：甲状腺功能减退症(简称甲减)是指甲状腺自身分泌的甲状腺素减少,机体代谢活动下降,而引起的一系列全身症状的疾病。症状较轻者临床表现不明显,重者可出现脸面浮肿,听力下降、智力减退等症状。由于甲减和贫血的临床症状有许多相似之处,治疗上容易忽略甲减伴有贫血并存的情况。甲减症状与贫血症状相互掩盖,容易发生漏诊和误诊,进而延误治疗。山东中医药大学李光善教授长期从事甲状腺疾病诊治,认为甲减伴贫血起病于肝郁,气虚气郁互为因;肝郁抑脾肾,痰浊瘀血贯始终。李教授提出以调肝和气生血、顺气化痰祛瘀、温补理气等为治则,利用调肝法治疗甲减伴贫血,在临床取得良好的疗效,同时提示治疗本病不仅重视补血,更要重视肝在本病发生发展中的重要作用,疏肝气、清肝火、养肝血、补肝气并行,化痰浊去瘀血去标实兼备,待肝气畅达,再予补血之品,则血虚易纠。文章通过整理李光善教授的相关理论分析,使用一则甲减伴贫血临床案例的诊疗和分析进行佐证,将其经验总结归纳,以为临床提供参考。Hypothyroidism refers to the decrease of thyroxine secreted by the thyroid gland itself and the decrease of metabolic activity of the body,and caused a series of systemic symptoms of the disease.Symptoms of mild clinical manifestations are not obvious,heavy cases can appear face edema,hearing loss,hypophrenia and other symptoms.Due to many similarities between the clinical symptoms of hypothyroidism and anemia,it is easy to ignore the situation of hypothyroidism with anemia.Hypothyroidism symptoms and anemia symptoms cover each other,prone to missed diagnosis and treatment.Professor LI Guangshan of Shandong University of Traditional Chinese Medicine has been engaged in the diagnosis and treatment of thyroid diseases for a long time.It is believed that hypothyroidism with anemia begins in liver depression,and Qi(气)deficiency and Qi depression are the protective cause.Liver depression suppresses the spleen and kidneys,and phlegm and stasis are always through.Professor LI proposed to regulate the liver and Qi to generate blood,smooth Qi to dissolve phlegm and remove stasis,warm and regulate Qi as the treatment principle,the use of liver regulation method to treat hypothyroidism with anemia,in the clinical effect to achieve good results,at the same time suggesting that the treatment of this disease not only attaches importance to blood supplementation,but also should pay attention to the important role of the liver in the occurrence and development of the disease,loosen liver Qi,clear liver fire,nourish liver blood,replenish liver Qi in parallel,dissolve phlegm and turbidity and remove blood stasis to standardize and have both solid and solid products,and when the liver Qi is unimpeded,and then give blood replenishment,then blood deficiency is easy to correct.This article organizes the relevant theoretical analysis of Professor LI Guangshan and uses the diagnosis and treatment and analysis of a clinical case of hypothyroidism and anemia to support it,and summarizes its experience to provide clinical reference.

关 键 词：甲状腺功能减退 贫血 临床经验 

分 类 号：R581.2[医药卫生—内分泌]