唐汉钧治疗桥本氏甲状腺炎经验总结

TANG Hanjun′s Experience in Treatment of Hashimoto′s Thyroiditis

桥本氏甲状腺炎(Hashimoto′s thyroiditis,HT)是一种慢性自身免疫性甲状腺疾病。现代医学对于该病的治疗以激素、免疫疗法、手术治疗等为主,对于TPOAb、TGAb的降低束手无策,中医药防治HT具有独特的优势,有助于缓解临床症状和缩短病程。HT古代没有明确的病名记载,但根据其发于颈部的特点及临床证候表现,归属于瘿病范畴。全国名老中医药专家唐汉钧教授对本病的诊治有着丰富的临床经验:认为与肝、脾关系最为密切。多见于中青年女性,常有慢性咽炎、反复感冒等病史,正气虚弱易感受风温外邪;情志不畅而肝郁,工作劳累而伤脾,致痰凝、瘀血互结客于颈前结喉。治疗上提出"扶正清瘿"法,多选用疏肝、理气、健脾、化痰散结等药物;强调根据患者甲状腺激素水平及免疫功能的变化分期辨证论治:甲状腺功能正常期、甲状腺功能亢进期(甲亢期)、甲状腺功能减退期(甲减期)。并附本病正常期、甲亢期、甲减期验案3则。

Hashimoto′s thyroiditis(HT)is a chronic autoimmune thyroid disease.Modern medicine treats this disease with hormone,immunotherapy and surgical treatment,but there is no way to reduce TPOAb and TGAb.TCM has unique advantages in HT prevention and treatment,which is helpful to alleviate clinical symptoms and shorten the course of the disease.There is no definite name of HT in ancient times,but it is classified as wart diseaseaccording to itspathogenic site and clinical manifestations.Professor TANG Hanjun,a national famous expert of TCM,has rich clinical experience in the diagnosis and treatment of this disease.He believes that the disease is most related to the liver and spleen.It is more common in young and middle-aged women with a history of chronic pharyngitis and repeated colds.He believes that the disease due to the windwarmand weak Qi.Low emotioncauses liver depression and work fatigue causes spleen injury,which lead to phlegm and blood stasis in the throat.Strengthening the vital Qi and clearingthe gall method was to be formulated.Chinese medicines are mostly used for soothing liver,regulating Qi,strengthening spleen,resolving phlegm and dispersing phlegm.According to the thyroid hormone level and immune function of patients,the treatments are carried out by stages and syndrome differentiation:normal thyroid function stage,hyperthyroidism stage(hyperthyroidism stage),hypothyroidism stage(hypothyroidism stage).Three additional cases were attached.