甲状腺术后声音嘶哑中医治疗研究进展  

A review on treating hoarseness after thyroid surgery in TCM

作　　者：陈新杰 王宽宇[1] 孔祥定 陈静[1] CHEN Xinjie;WANG Kuanyu;KONG Xiangding;CHEN Jing

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《中医临床研究》2023年第12期145-148,共4页Clinical Journal Of Chinese Medicine

摘　　要：甲状腺术后声音嘶哑是甲状腺外科疾病中常见的并发症,多是因为术中物理性因素或术后局部病理因素直接或间接损伤喉返神经所造成,给患者生理和心理带来双重负担。术后声音嘶哑虽属于中医“喉喑”的范畴,但在病因病机上又有其特殊之处,术后初期以甲状腺区域术野暴露时间过长,手术损伤造成痰阻喉窍,化热伤津等实证为主,后期则出现气阴亏虚,声道失于濡养,虚实夹杂,同时因经脉损伤导致气血瘀阻于喉间导致声门开阖不利,气息运行不畅,出现声音嘶哑。而西医以常规的营养神经和激素抗感染治疗,方法单一且疗效不理想,易出现不良反应,患者接受度低,而中医以中医辨证治疗、局部针灸、中药超声雾化疗法、内外合治、中西结合为主。内治根据不同症状,临床上证型以气阴两虚证、痰瘀阻窍证居多,用药以开音、收涩药为主,结合滋补肺胃气阴可取良效,外治以局部针灸、超声雾化吸入为主,雾化吸入采用滋阴清热利咽之药,而以维生素、甲钴胺等营养神经药以及糖皮质激素联合中药汤剂、中药雾化吸入中西医结合治疗,双管齐下,取效更优。文章通过综述近年来中医对术后声音嘶哑的治疗进展,阐述优势与不足,展望未来,以期为进一步提高临床治疗质量提供参考。Hoarseness after thyroid surgery is a common complication in thyroid surgical diseases.It is mainly caused by physical factors during surgery or local pathological factors after surgery,which directly or indirectly damages the recurrent laryngeal nerve,and brings double physiological and psychological burden to patients.Although postoperative hoarseness belongs to the category of laryngostasis in TCM,it has its special features in the etiology and pathogenesis.In the early postoperative period,the thyroid area is exposed for too long,the operation injury causes phlegm to block the throat,heat and fluid injury and other empirical evidences,and in the later period,there is deficiency of Qi(气)and Yin(阴),loss of vocal tract in mutual support,which is mixed with deficiency and excess.At the same time,due to the damage of the meridians,Qi and blood stasis obstructs the throat,leading to the dysfunction of opening and closing of the glottis,the breath is not smooth,and the voice is hoarse.Western medicine uses conventional neurotrophic and hormonal anti-inflammatory therapy with single method and unsatisfactory efficacy,which is prone to bring adverse reactions and low acceptance of patients,while TCM mainly uses syndrome differentiation treatment,local acupuncture,ultrasonic atomization therapy TCM medicine,internal and external treatment,and the combination of TCM and Western medicine.Internal treatment is given according to different symptoms,the clinical types of include Qi and Yin deficiency syndrome,and phlegm and blood stasis syndrome,the medication is mainly to restore the sound and astringency,combined with nourishing lung and stomach Qi and Yin to achieve good effect;external treatment mainly includes local acupuncture and moxibustion,ultrasonic atomizing inhalation.Atomizing inhalation was given for nourishing Yin and clearing heat with pharyngeal drug.Nutritional neurotropic drugs such as vitamin,mecobalamine and glucocorticoid plus TCM decoction and TCM medicine aerosol inhalation can achieve better eff

关 键 词：甲状腺术后 声音嘶哑 中医治疗法 

分 类 号：R653[医药卫生—外科学]