从“罢极之本”论治甲状腺结节  

Analysis on the Effect Principle of Treating Thyroid Nodule from“Source of Endurance”

作　　者：宫成军[1] 崔鹏[1] 马晓燕[1] GONG Chengjun;CUI Peng;MA Xiaoyan(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2023年第5期1-4,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81874441);第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号)。

摘　　要：探讨从“罢极之本”论治甲状腺结节的临床意义,为甲状腺结节治疗拓展思路。通过查阅中医古籍和现代文献,搜集部分医家对“罢极之本”理论的学术观点,探讨“罢极之本”理论内涵,从“罢极之本”提炼甲状腺结节的病因病机、临证思路和用药特色,并附一则医案加以验证。从“罢极之本”探析甲状腺结节病机核心在于肝之体用和生理功能失常为先、肝脏维持脏腑生理功能失常为变,最终导致气滞、血瘀、痰凝壅结颈前发病,关键环节在于“罢极之本”职能特性失常,治疗方面特此提出“肝实者宜疏泄、肝虚者宜柔补”总则,通过疏肝解郁、疏肝活血、培土缓肝、柔肝养血、清肝泻火的不同遣方用药思路而达到散结消瘿的目的,所举验案为肝郁气滞、痰凝血瘀之甲状腺结节,以疏肝理气、化痰活血、软坚散结为治则,方选自拟疏肝散结消瘿方治疗,临床获效显著。从“罢极之本”论治甲状腺结节合理可靠,建立甲状腺结节特色辨治体系,可为今后中医药治疗甲状腺结节提供更为广阔的思路和方法。To explore the clinical significance of treating thyroid nodule from“source of endurance”and expand ideas for the treatment of thyroid nodule.Through consulting the ancient books and modern literature,collecting the academic views of some doctors on the theory of“source of endurance”,discussing the theoretical connotation of“source of endurance”,extracting the etiology,pathogenesis,clinical syndrome differentiation and treatment ideas and medication characteristics of thyroid nodules.One case was presented for verification.The core of the pathogenesis of thyroid nodule from“source of endurance”lies in that the body function of the liver and the physiological dysfunction and the liver maintains the physiological dysfunction of the Zang-Fu organs,and finally leads to the onset of Qi stagnation,blood stasis and phlegm congealing.The key link lies in the functional characteristics of“source of endurance”.Therefore,the treatment of thyroid nodule should take“tonifying deficiency and reducing excess”as the general principle of treatment,and achieve the purpose of resolving masses and eliminating goiter through the differences of dispersing stagnated liver Qi and relieving Qi stagnation and promoting blood circulation,invigorating spleen and releasing liver,softening liver and nourishing blood,clearing liver-fire,so as to provide a theoretical basis for the prevention and treatment of thyroid nodule.The case is a thyroid nodule with liver depression and Qi stagnation,phlegm coagulation and blood stasis.The treatment principle is to soothe liver and regulate Qi,remove phlegm and activate blood circulation,and soften the hardness and disperse the knot.The self-made prescription of dispersing the liver,dispersing the knot and eliminating the gall is selected for treatment,and the clinical effect is remarkable.Based on“source of endurance”,the syndrome differentiation and treatment of thyroid nodule is reasonable and reliable.The establishment of characteristic syndrome differentiation and treatm

关 键 词：罢极之本 甲状腺结节 疏肝解郁 疏肝活血 培土缓肝 柔肝养血 清肝泻火 

分 类 号：R259[医药卫生—中西医结合]