慢性淋巴细胞性甲状腺炎亚临床期病机探析

Analysis of subclinical pathogenesis of chronic lymphocytic thyroiditis

慢性淋巴细胞性甲状腺炎(CLT)是临床常见的自身免疫性甲状腺疾病,以无疼痛、弥漫性甲状腺肿大,伴有甲状腺自身抗体滴度升高为特征。慢性淋巴细胞性甲状腺炎分为三期,CLT亚临床期治疗是逆转疾病进程关键阶段,该期患者呈现相对可逆性,如早期进行干预,能够逆转其向甲状腺功能异常期进展,中医对CLT亚临床期的辨证治疗具有独特优势。本文从CLT亚临床期的中医病机特点,结合CLT亚临床期的临床表现及病理特点,阐述CLT亚临床期发病的中医病机核心是肝郁脾虚,以及其与西医免疫功能紊乱、甲状腺细胞凋亡的相关性为切入点探析CLT亚临床期发病机制,为慢性淋巴细胞性甲状腺炎亚临床期的治疗提供坚实理论依据。

Chronic lymphocytic thyroiditis(CLT)is a common autoimmune thyroid disease in clinic.It is characterized by painless,diffuse goiter and high titer of thyroid autoantibody.The stages of chronic lymphocytic thyroiditis are subclinical stage,hyperthyroidism stage and hypothyroidism stage.The treatment of CLT in subclinical stage is the key stage to reverse the disease process.The patients in this stage are relatively reversible.If early intervention,it is possible to reverse the progression to abnormal thyroid function.TCM has unique advantages in the treatment of CLT in subclinical stage.Based on the characteristics of TCM pathogenesis in subclinical stage of CLT,combined with the clinical manifestations and pathological characteristics of CLT,this paper expounds that the core of TCM pathogenesis of CLT in subclinical stage is liver depression and spleen deficiency,and its correlation with immune function disorder and thyroid cell apoptosis in western medicine as the breakthrough point to explore the pathogenesis of CLT subclinical stage,so as to improve the treatment of chronic lymphocytic thyroiditis in subclinical stage.