基于中观、微观“气化”理论探讨桥本甲状腺炎的发病机制  

Discussion on the Pathogenesis of Hashimoto's Thyroiditis Based on Meso and Micro“Gasification”Theory

作　　者：刘婧 孙欣[2] 安杨 张国栋 董佳妮[3] 伊桐凝[3] 张兰[3] LIU Jing;SUN Xin;AN Yang;ZHANG Guodong;DONG Jiani;YI Tongning;ZHANG Lan(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Shenyang Second Hospital of Traditional Chinese Medicine,Shenyang 110101,Liaoning,China;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,辽宁沈阳110847 [2]沈阳市第二中医医院,辽宁沈阳110101 [3]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》2024年第4期140-144,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。

摘　　要：气化理论是《黄帝内经》中记载,用以阐释生命过程、疾病的中医机制。中医多认为桥本甲状腺炎(HT)的病机与外邪侵袭、水土失宜或情志内伤,肝失疏泄,或因先天不足,或因后天失养,从而产生气滞、痰凝、血瘀等病理产物壅结于颈前有关。气化以气机调畅为基础和前提,中观、微观气化与人体关系密切,可分别在精微物质生成、精微物质代谢、病理形态、经络上对HT产生一定的影响。因此文章基于中观、微观“气化”探讨环境及肝脾肾失调对HT发病的影响。基于中观气化理论,HT的发病核心病机以外邪侵袭,水土、饮食失宜为主;基于微观气化理论,HT的发病核心病机为肝脾肾失调。从先天不足、后天失养(精气不足,津血乏源),肝失疏泄,气机失调(气滞血瘀,水停精滞);或留滞不化,结聚成形;或经络失养、涩滞不行探讨HT的发病机制,以期开创以气化理论为基础的HT中医治疗新思路。The theory of gasification is recorded in Inner Canon of Huangdi,which is used to explain the mechanism of life process and diseases in traditional Chinese medicine.Traditional Chinese medicine believes that the pathogenesis of Hashimoto's thyroiditis(HT)is related to the invasion of external evils,water and soil maladjustment or emotional internal injury,liver loss and laxity,or congenital deficiency,or acquired dystrophy,resulting in Qi stagnation,phlegm coagulation,blood stasis and other pathological products in front of the neck.Gasification is based on and premised on the smooth regulation of the Qi engine.The mesoscopic and microcosmic gasification are closely related to the human body,and can have a certain impact on HT respectively in the generation of fine and micro substances,metabolism of fine and micro substances,pathological morphology,and meridians.Therefore,this paper discusses the influence of environment and the imbalance of liver,spleen,and kidney on the pathogenesis of HT based on mesoscopic and microcosmic“gasification”.Based on the mesoscopic gasification theory,the core pathogenesis of HT is the invasion of external evils,and the main cause is the inappropriateness of water and soil diet;Based on the micro gasification theory,the core pathogenesis of HT is the imbalance of liver,spleen,and kidney.From congenital deficiency,acquired dystrophy(deficiency of essence and Qi,lack of source of fluid and blood),liver failure to relieve,and imbalance of Qi(stagnation of Qi and blood,stagnation of water and essence);Or remain unchanged and agglomerate to form;To explore the pathogenesis of HT,we hope to open up a new way of TCM treatment of HT based on the theory of gasification.

关 键 词：气化理论 桥本甲状腺炎 病机 肝脾肾 

分 类 号：R22[医药卫生—中医基础理论]