从“肝阳虚”论治女性原发性甲状腺功能减退症  

Treatment of Female Primary Hypothyroidism from"Deficiency of Liver-Yang"

作　　者：肖菊 徐健众[2] XIAO Ju;XU Jianzhong(Hunan University of Chinese Medicine,Hunan Changsha 410208,China;Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]重庆市中医院,重庆400021

出　　处：《中医药临床杂志》2024年第12期2319-2323,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：重庆市巴渝岐黄学者(渝中医[2023]23号);重庆英才名家名师(cstc2022ycjh-bgzxm0132)。

摘　　要：原发性甲状腺功能减退症以精神疲软、表情呆滞等全身低代谢状态为主要临床表现,严重影响患者生活质量,现代医学目前以替代治疗为主,需长期甚至终身服药。该病属中医“瘿病”“劳瘿”“虚劳”等范畴,研究表明女性为该病好发群体,徐健众主任中医师认为,女子以肝为先天,肝阴血虚耗是常态,加之现代女性社会压力大,易受各种负面情绪影响,导致肝气郁结,气血津液失调,郁久化火伤阴。如果阴损及阳,或者先天脏腑娇弱、禀赋阳气不足,亦或因年老体衰、他脏累及,甲减发病日久可见肝阳虚衰的表现。总而言之,肝阳虚损、疏泄不及是其主要病机,肝经、肝系失于濡养、温煦是其临床表现。辨治重视温肝散寒,疏肝理气,同时化痰散结,并兼顾补脾益肾,临床运用可收获不错的疗效。Primary hypothyroidism is characterized by mental fatigue,dull expression and other systemic low metabolism states as the main clinical manifestations,which seriously affect the quality of life of patients.Modern medicine currently focuses on replacement therapy,which requires long-term or even life long medication.This disease belongs to the category of“goiter”,“fatigue goiter”and“deficiency fatigue”in traditional Chinese medicine.Studies have shown that women are the most susceptible group to this disease.Chief Chinese medicine physician XU Jianzhong believes that women are born with liver,and liver Yin and blood deficiency is normal.In addition,modern women are under great social pressure and are easily affected by various negative emotions,which leads to liver Qi stagnation,Qi,blood and body fluid imbalance,and long-term stagnation turns into fire and damages Yin.If Yin damages Yang,or if the congenital organs are delicate and the endowment Yang is insufficient,or if it is due to old age and physical weakness,or other organs are involved,the symptoms of liver Yang deficiency can be seen after a long period of hypothyroidism.In short,liver Yang deficiency and insufficient drainage are its main pathogenesis,and liver meridians and liver systems are not nourished and warmed as its clinical manifestations.Treatment focuses on warming the liver and dispersing cold,soothing the liver and regulating Qi,resolving phlegm and dispersing nodules,and taking into account tonifying the spleen and kidney.Clinical application can achieve good results.

关 键 词：原发性甲状腺功能减退症 肝阳虚 中医诊治 名医经验 

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