吴敏教授运用“温病”理论临床辨治早中期亚急性甲状腺炎  

Professor WU Min′s Clinical Differentiation and Treatment of Early and Middle Stages of Subacute Thyroiditis Using"Warm Disease"Theory

作　　者：乔梁 刘滟琳 许玲玲[1] 张丽娟[1] 曹琳[1,2] QIAO Liang;LIU Yanin;XU Linging;ZHANG Lijuan;CAO Lin(Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing China;Jiangsu Provincial Academy of Chinese Medicine,Nanjing China)

机构地区：[1]南京中医药大学附属中西医结合医院,江苏南京210028 [2]江苏省中医药研究院,江苏南京210028

出　　处：《中医药信息》2024年第8期63-66,共4页Information on Traditional Chinese Medicine

基　　金：国家中医临床研究基地开放课题项目(JD2022SZXZD03)。

摘　　要：亚急性甲状腺炎属“瘿痛”范畴。吴敏教授在“瘿痛”的临床辨治中,认为本病是由外感温热邪毒及内伤七情,致气血不畅,痰凝血瘀,壅结颈前而发,表现为发热、颈部肿大、疼痛等。中期邪热日久,耗伤阴津,则阴虚火旺,故见心悸汗出,口燥咽干,颈部隐痛等。根据本病的病机演变规律,结合“温病”理论及临床经验,吴敏教授提出了“瘿痛”早中期“卫气营”分期论治的辨治原则,早期为“卫分”即将入“气分”的热毒蕴结证,治疗以清热解毒、消瘿止痛为主,自拟“银翘消瘿止痛汤”;中期为“营阴耗伤”的阴虚火旺证,治疗以滋阴泻火、消瘿散结为主,自拟“增液消瘿散结汤”,临床疗效显著。Subacute thyroiditis falls under the category of"Goiter Pain".Professor WU Min,in the clinical differentiation and treatment of Goiter Pain believes that this disease is caused by external pathogenic heat toxins and internal emotional injuries,leading to qi and blood stagnation,phlegm coagulation,and blood stasis,which obstruct the anterior neck,manifesting as fever,neck swelling,and pain.In the middle stage,prolonged pathogenic heat damages yin fluids,resulting in yin deficiency with effulgent fire,hence symptoms such as palpitations,sweating,dry mouth and throat,and dull neck pain occur.According to the pathogenesis and evolution of this disease,combined with the"Warm Disease"theory and clinical experience,Professor WU Min proposed the differentiation and treatment principle of"defense,qi and nutrient"stages for early and middle stages of the disease.Early stage is"defense stage"with heat toxin accumulation about to enter the"qi stage,"which should be treated mainly by clearing heat,detoxifying,reducing goiter,and relieving pain,using a self-made"Yinqiao Xiaoying Zhitong Decoction."In the middle stage,it is characterized by yin deficiency with effulgent fire due to depletion of"nutrient yin",treated mainly by enriching yin,purging fire,reducing goiter,and dispersing nodules,using a self-made"Zengye Xiaoying Sanjie Decoction,"with significant clinical efficacy.

关 键 词：亚急性甲状腺炎 分期论治 吴敏教授 清热解毒 滋阴泻火 

分 类 号：R249[医药卫生—中医临床基础] R259[医药卫生—中医学]