基于“形神一体观”理论从肝脾探讨甲状腺结节的辨治  

The diagnosis and treatment of thyroid nodules from the aspects of liver and spleen based on the theory of holism of physique and spirit

作　　者：马嘉遥 冷锦红[2] MA Jiayao

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中医临床研究》2024年第34期61-66,共6页Clinical Journal Of Chinese Medicine

基　　金：张静生国医大师传承工作室项目(2022-304)。

摘　　要：“形神一体观”是中医学整体观念的重要体现,强调形与神二者相互依赖、相互影响、互根互生,若形神相失,则脏腑失调,气机不畅,百病丛生。甲状腺结节是内分泌系统的常见疾病,大部分患者临床没有明显的不适症状,结节较大对周围组织造成压迫的患者会表现出吞咽困难、声音嘶哑甚至呼吸困难等。现代医学尚未对甲状腺结节的成因作出充分解释,已知环境、饮食、遗传、情绪、不良生活习惯等是主要的危险因素,目前没有治疗本病的特效药物。甲状腺结节属于中医学“瘿病”范畴,中医药治疗本病具有悠久的历史,疗效显著。本研究基于形神一体观理念,结合中医理论与现代医学研究,认为甲状腺结节属于“形神同病”,其发生发展主要责之于肝、脾。长期的情志不舒、饮食失宜导致肝失条达、脾失健运,气滞、痰凝、血瘀等病理产物凝结于颈部,发为甲状腺结节。临床治疗本病以调治肝脾为主,标本兼治,并重视形神同调,以期拓展中医防治甲状腺结节的思路。The concept of holism of physique and spirit is an important embodiment of the overall concept in traditional Chinese Tmedicine(TCM),emphasizing the interdependence,mutual influence,and mutual root of physique and spirit.Discordance between physique and spirit can cause viscera dysfunction,depressed Qi(气)circulation,resulting in many diseases.Thyroid nodule is a common disease of endocrine system,and most patients have no obvious clinical discomfort.Patients with large nodules that cause pressure on surrounding tissues have clinical symptoms such as dysphagia,hoarseness and even breath with difficulty.Modern medicine has not fully explained the cause of thyroid nodules,and it is known that the environment,diet,heredity,mood,and bad living habits are the main risk factors.Currently,there is no specific medicine to treat this disease.Thyroid nodules belong to the category of goitre disease in TCM.TCM has a long history in the treatment of thyroid nodules,with remarkable curative effects.Based on the concept of the holism of physique and spirit,combined with TCM relevant theories and modern medical research,it is believed that thyroid nodules are the concurrent diseases of physique and spirit,and their occurrence and development are due to liver and spleen.Long-term emotional discomfort and improper diet lead to liver depression and spleen dysfunction,and Qi stagnation,phlegm coagulation,blood stasis and other pathological products coagulate in the neck,resulting in thyroid nodules.The clinical treatment of thyroid nodules should focus on regulating liver and spleen,treating both symptoms and root causes,and paying attention to harmonize physique and spirit,in order to expand the ideas of prevention and treatment of thyroid nodules in TCM.

关 键 词：形神一体观 甲状腺结节 肝失疏泄 脾失健运 调治肝脾 

分 类 号：R265[医药卫生—中医外科学]