王志刚主任医师从肝论治亚临床甲状腺功能减退症经验

Chief Physician WANG Zhigang’s experience in treating subclinical hypothyroidism from the perspective of liver

王志刚主任医师在30余年的临床工作中,对亚临床甲状腺功能减退症的治疗有丰富的经验,认为本病病机多因肝气郁结,肝主疏泄之生理特性失调,进而影响体内气血津液运行。病位重点在于肝,并根据临床证候分3期论治:初期为肝经郁热证,多用龙胆泻肝汤加减;中期以气滞痰凝证多见,用失笑散合丹参饮加减治疗;后期以阴虚热郁证、肝肾阴虚证多见,分别用四逆散合增液汤加减及六味地黄丸加减治疗,均在临床中获效显著。

Chief Physician WANG Zhigang has extensively clinical experience in the treatment of subclinical hypothyroidism in his clinical work for more than 30 years.He believes that the pathogenesis of this disease is mainly due to liver Qi-stagnation(肝气郁结),the physiological dysfunction of liver governing dredging,which further affects the movement of Qi(气),blood and body fluid in the body.The focus of the disease is on the liver,and the treatment is divided into 3 stages according to the clinical symptoms.In the initial stage of the disease,the Longdan Xiegan decoction(龙胆泻肝汤)was used mainly to clear stagnation and heat in the liver meridian.In the middle stage of the disease,Shixiao San(失笑散)plus Danshen Yin(丹参饮)was mainly used to treat Qi-stagnation and phlegm coagulation syndrome.In the later stage of the disease,Sini San(四逆散)plus the Zengye decoction(增液汤)was mainly applied to treat Yin-deficiency(阴虚)and heat stagnation syndrome,and Liuwei Dihuang Wan(六味地黄丸)was applied mainly to treat Yin-deficiency of spleen and kidney syndrome.All the above methods show significant effects.