调气分期论治亚急性甲状腺炎  

Treating Subacute Thyroiditis by Regulating Qi in Stages

作　　者：曹宏业 高阎满 孙佳佳 谭丽 张军 Cao Hongye;Gao Yanman;Sun Jiajia;Tan Li;Zhang Jun(Tangshan Fengnan District Tradional Chinese Medicine Hospital,Hebei,Tangshan 063300,China)

机构地区：[1]河北省唐山市丰南区中医医院,河北唐山063300 [2]河北省唐山市中医医院,河北唐山063000 [3]清华大学玉泉医院,清华大学中西医结合医院,北京100040

出　　处：《中国中医急症》2025年第1期72-76,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2021400,2024436)。

摘　　要：亚急性甲状腺炎(SAT)是一种自限性的非细菌感染的甲状腺疾病,西医治疗存在一定的副作用及较高的复发率,中医治疗SAT具有独特优势。笔者认为气之虚余与SAT发病密切相关,其中气机郁滞、正气亏虚在SAT发生发展中占据主导地位,提出治SAT以调气为要,并根据SAT各期的病机侧重点分期治疗,即急性甲亢期以邪实为主,治以疏风散热、疏肝解郁以理气行;缓解甲减期邪盛正虚,治以祛湿化痰、活血化瘀、益气健脾以纠气和;慢性恢复期正虚邪退,治以益气养阴、理气行滞以复气顺。临床运用调气分期诊治SAT具有较好的临床疗效,并附上1则验案。Subacute thyroiditis(SAT)is a self-limiting,non-bacterial inflammatory thyroid disease.While western medicine treatments for SAT have certain side effects and a higher recurrence rate,traditional Chinese medicine(TCM)offers unique advantages in treating this condition.The authors believe that the deficiency and excess of qi are closely related to the onset of SAT,with qi stagnation and deficiency of righteous qi playing dominant roles in its development.Therefore,we propose that regulating qi is essential in the treatment of SAT and suggest a staged approach based on the pathogenesis at different phases of the disease.Specifically,during the acute hyperthyroid phase,characterized mainly by pathogenic factors,the treatment should focus on dispelling wind,clearing heat,soothing the liver,and resolving depression to regulate qi flow.In the hypothyroid recovery phase,where both pathogenic factors and deficiency coexist,the therapy should aim at removing dampness,transforming phlegm,activating blood circulation to remove stasis,and tonifying qi to strengthen the spleen,thereby harmonizing qi.During the chronic convalescence phase,as the body′s righteous qi gradually recovers and pathogenic factors retreat,the treatment should emphasize tonifying qi and nourishing yin,regulating qi,and resolving stagnation to restore smooth qi flow.This staged therapeutic approach has demonstrated good clinical efficacy.A case study is also provided to illustrate the effectiveness of this method.

关 键 词：亚急性甲状腺炎 气之虚余 调气 分期论治 

分 类 号：R581.4[医药卫生—内分泌]