基于络病理论探讨亚急性甲状腺炎防治体系的建立

Study on the prevention and treatment system of subacute thyroiditis based on collateral disease theory

文章以'络病'学说为理论基础,结合临床经验及中西医对于亚急性甲状腺炎(SAT)的研究进展,提出脉络亏虚,热毒滞络为主要病机;以清补(扶正补虚,清热解毒)络脉、分期论治为SAT的治则。可将SAT分为早期(外感期)、中期(甲亢期)、后期(甲减期或恢复期)。各期主要证型分别为风温犯肺,络气郁热;肝火亢盛或气阴两虚,热毒阻络;阳气亏虚,络息成积。各期分别予以相应治法并酌情选取荣养络脉、清热通络等中药组方施治,进而为SAT的治疗提供新思路。

Based on the theory of’collateral disease’as the theoretical basis,combining with the clinical experience and the research of traditional Chinese medicine and western medicine on subacute thyroiditis(SAT),this article put forward meridians deficiency and heat toxin stagnation of collaterals as the main pathogenesis of SAT,proposed that clearing and nourishing collateral and treatment based on different stages as the principle of treating SAT.SAT can be divided into early stage(exogenous pathogenic stage),medium stage(hyperthyroidism stage)and later stage(hypothyroidism stage or recovery period).The main syndromes types of different stages were wind-warm invading the lung,collateral qi heat retention;exuberance of liver fire or deficiency of both qi and yin;deficiency of yang qi and collaterals stagnation accumulating into amassment.Each period was given corresponding treatment seperately,and appropriate selection of medicine for nourishing collaterals,clearing heat and dredging collaterals based on syndrome differentiation,hoping to provide a new idea for the treatment of SAT.