基于“阳有余而阴不足”理论治疗甲状腺功能亢进症  

Treating hyperthyroidism based on the theory of"excess yang and insufficient yin"

作　　者：苏琳[1] 张丽萍 王聪慧 陈巧楠 娄锡恩 SU Lin;ZHANG Liping;WANG Conghui;CHEN Qiaonan;LOU Xi'en(The Third Clinical Medical School,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Endocrinology,The Third Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学第三临床医学院,北京100029 [2]北京中医药大学第三附属医院内分泌科,北京100029

出　　处：《湖南中医药大学学报》2024年第10期1886-1891,共6页Journal of Hunan University of Chinese Medicine

基　　金：国家重点研发计划课题(2019YFC1710403)。

摘　　要：甲状腺功能亢进症是临床常见的高代谢性疾病,西医治疗复发率高、副作用大,而中医治疗甲状腺功能亢进症具有较好的临床疗效。基于朱丹溪提出的“阳有余而阴不足”理论,对甲状腺功能亢进症的中医病因病机及各阶段治疗展开论述。该理论揭示了甲状腺功能亢进症的致病核心,提出了甲状腺功能亢进症的病理基础为“阴不足”,病理表现为“阳有余”。临证时,应针对其不同时期的病理特点辨证论治:疾病初起时实邪当泻,注重解郁泻火;疾病进展时多见虚实夹杂,需补虚泻实,既固护真阴又化痰逐瘀;疾病日久则重在平秘阴阳。附临床验案一则,以期为临床辨证论治提供参考。Hyperthyroidism is a common high-metabolic disease in clinical practice.Western medicine treatment has a high recurrence rate and significant side effects,whereas Chinese Medicine offers better clinical efficacy in treating hyperthyroidism.This paper,based on ZHU Danxi's theory of"excess yang and insufficient yin",discusses the TCM etiology and pathogenesis of hyperthyroidism,as well as the treatment at various stages.The theory reveals the core pathogenesis of hyperthyroidism,suggesting that the pathological basis of hyperthyroidism is"insufficient yin",which manifests as"excess yang".In clinical practice,treatments should be tailored to the distinct pathological characteristics at the different stages of this disease:during the initial stage,where excess pathogens should be reduced,resolving stagnation and reducing fire should be emphasized;in the progressive stage,where a mixture of deficiency and excess is common,it is necessary to tonify deficiency and reduce excess simultaneously,consolidating the primordial yin and transforming phlegm and eliminating blood stasis;in the prolonged cases,the focus should be on balancing yin and yang.A verified medical record is provided as a reference for the pattern differentiation and treatment in clinical practice.

关 键 词：甲状腺功能亢进症 阳有余 阴不足 阳亢阴亏 分期论治 

分 类 号：R259[医药卫生—中西医结合]