张广德从温病少阳证辨治亚急性甲状腺炎经验

Zhang Guangde’s experience in treating subacute thyroiditis from Wenbing Shaoyang syndrome

亚急性甲状腺炎(SAT)是一种以甲状腺肿大、疼痛伴发热为主要临床表现的甲状腺炎症疾病,针对SAT轻症患者,西医主要采用非甾体类抗炎药,严重者则合并使用糖皮质激素。西医治疗该病存在停药易反复、疗程长、不良反应多等问题。根据SAT临床表现,将其归属于中医“瘿病”范畴,中医药治疗SAT具有疗程短、疗效较好、不良反应少等优势。张广德教授认为SAT主要病因是外感温毒时邪伴情志失调,发病机制为少阳枢机不利,肝胆疏泄失常,气滞血凝痰结,主张从温病少阳证论治本病,以和解少阳、清热解毒为治疗大法,辅以疏泄肝胆、行气活血、化痰散结消痈药物,后期则注意顾护正气。

Subacute thyroiditis(SAT)is an inflammatory disease of the thyroid with goiter,pain and fever as main clinical manifestations.Western medicine mainly uses non-steroidal anti-inflammatory drugs in patients with mild SAT symptoms,and glucocorticoids in severe patients.Western medicine treatment is easy to stop repeatedly,long course of treatment,many adverse reactions and other problems.According to the clinical manifestations of SAT,it belongs to Yingbing of traditional Chinese medicine.Traditional Chinese medicine has the advantages of short course of treatment,good curative effect and less adverse reactions.Professor Zhang Guangde believes that the main cause of SAT is Wendu Shixie companion emotional disorder.The pathogenesis of SAT is that Shaoyang Shuji Buli,Gandan Shuxie abnormal,Qizhi Xueyu Tanjie.He treats the disease from Shaoyang syndrome of Wenbing,taking reconciliation of Shaoyang,Qingre Jiedu as the main treatment,supplemented by drugs for Shuxie Gandan,Xingqi Huoxue,Huatan Sanjie,Xiaoyong,and paying attention to Zhengqi in the later stage.