吴学苏教授治疗桥本甲状腺炎经验拾萃

Experience of Professor WU Xuesu in Treating Hashimoto Thyroiditis

[目的]归纳总结吴学苏教授对桥本甲状腺炎病因病机的认识及治疗经验。[方法]通过跟师学习,收集整理吴师多年诊治本病的典型医案,研究分析其临床辨证及遣方用药规律,归纳总结其治疗经验,并列举验案进行佐证。[结果]吴师结合中西医理论及多年临床经验,总结出本病最常见的病因是情志内伤,以痰浊内郁为重要病理环节,治疗上强调从痰论治,以二陈汤为基础方,根据不同证型辨证加减。同时在中医“治未病”理论指导下,合理运用中医药,干预本病发生进展,可有效避免或延缓不可逆甲减及癌变的发生。所举验案为桥本甲状腺炎亚临床甲减期,吴师据其“脾肾阳虚、痰浊内郁”的病机,以温肾健脾、化痰散结法治之,成功降低其抗体水平,避免临床甲减的发生。[结论]吴学苏教授治疗桥本甲状腺炎经验丰富且颇具疗效,其临证方法及诊治特色,对临床治疗桥本甲状腺炎具有重要指导意义。

[Objective]To generalize Professor WU Xuesu’s experience in treating Hashimoto thyroiditis.[Methods]Through clinical learning with Professor WU and reading the typical cases,Professor WU’s clinical dialectics and medication laws were analyzed,and the clinical experience of treatment of the disease was summarized.At the same time,one proven case was presented respectively.[Results]Integrating the theories of Chinese and western medicine and the clinical experience for decades,Professor WU concludes that the most common cause of the disease is the emotional factors,and phlegm stasis is the key pathogenesis.She emphasizes the treatment of the disease according to phlegm conditions.Based on Erchen decoction,the prescription is adjusted according to different TCM syndromes.Meanwhile,Professor WU rationally uses TCM treatments to intervene the occurrence and progress of this disease according to the guidance of the theory of Chinese medicine"treating pre-disease",which can effectively avoid or delay the occurrence of irreversible hypothyroidism and cancer.The case was diagnosed with Hashimoto thyroiditis with subclinical hypothyroidism.Professor WU believed that the patient′s main pathogenesis was Yang deficiency of spleen and kidney and phlegm stasis.By adopting the methods of warming spleen and kidney,softening hardness and reducing phlegm,the patient’s antibody volume decreased to normal level and hypothyroidism was prevented.[Conclusion]Professor WU has rich experience in the treatment of Hashimoto thyroiditis and the curative effect is satisfactory.Her creative clinical methods and characteristics of diagnosis and treatment provide important guidance to the clinical treatment of Hashimoto thyroiditis.