名中医李果烈基于和温消法活用桂枝汤治疗甲状腺功能减退症  

Li Guolie uses Guizhi decoction to treat hypothyroidism based on the methods of harmonizing warming and eliminating

作　　者：李楠楠 严云 陈永魁 陆艳[2] LI Nannan;YAN Yun;CHEN Yongkui;LU Yan(Graduate School,Nanjing University of Chinese Medicine,Nanjing 210001,China)

机构地区：[1]南京中医药大学研究生院,江苏南京210001 [2]南京中医药大学附属南京中医院脑病科,江苏南京210006

出　　处：《陕西中医》2024年第6期815-819,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81804022);全国中医药创新骨干人才项目[国中医药人教函(2019)128号];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：甲状腺功能减退症是临床常见的内分泌疾病,其病情复杂、病因多样,名中医李果烈综合患者体质、情志、环境等多方面因素,分析判断其症候特点,抓住疾病的主要病机。李果烈教授认为甲状腺功能减退症是甲状腺激素水平低下致使全身机能不足而发,属虚损性疾病,“失和”为疾病的本质,病变之本在于阳虚寒凝,发病之标为浊邪阻滞,因此甲状腺功能减退症为本虚标实之证,而又以正虚为主。在治疗方面,李果烈教授提出以“和”为核心、温为首要、消法兼治的治疗法则,临床上常采用桂枝汤化裁加减,围绕“和法”,主以平调阴阳、调和肝脾、调气和血,强调虚实并治以及温补周身阳气的重要性,同时兼顾痰湿、气滞、瘀血等邪实,辨证施治,全面兼顾病机,达到改善临床症状之目的。Hypothyroidism is a common endocrine disease in clinic.Its condition is complex and its etiology is diverse.Professor Li Guolie synthesizes the patient’s constitution,emotion,environment and other factors,analyzes and judges its symptom characteristics,and grasps the main pathogenesis of the disease.Professor Li Guolie believes that hypothyroidism is caused by the low level of thyroid hormone,which leads to the lack of systemic function.It is a debilitating disease.“Disharmony”is the essence of the disease.The root of the disease is yang deficiency and cold coagulation,and the sign of onset is turbid pathogen block.Therefore,hypothyroidism is the syndrome of deficiency in origin and excess in superficiality,and is mainly based on positive deficiency.In terms of treatment,Professor Li Guolie proposed a treatment rule with“harmonizing”as the core,warmth as the primary,and elimination as the common treatment.In clinical practice,Guizhi decoction is often modified.Around the method of“harmonizing”,it mainly regulates yin and yang,reconciles liver and spleen,regulates qi and blood,emphasizes the importance of simultaneous treatment of deficiency and excess,and warms the yang qi of the whole body.At the same time,it also takes into account phlegm dampness,qi stagnation,blood stasis and other evils,and treats them according to syndrome differentiation,taking into account the pathogenesis of the disease in an all-round way,so as to achieve the purpose of improving clinical symptoms.

关 键 词：甲状腺功能减退症 失和 调和阴阳 消法 阳虚 浊邪阻滞 

分 类 号：R581.2[医药卫生—内分泌]