基于“阳虚阴结”理论辨治甲状腺结节

Treatment of Thyroid Nodules Based on Theory of“Yang Deficiency and Yin Stagnation”

甲状腺结节为有形之体,其病机关键为“阳虚阴结”,阳虚为本,阴结为要,盖因机体阳化气不足,温煦推动无权,以致阴成形太过,精血津液失于温通,布散失常,痰湿瘀滞暗生,日久凝结局部,临证当温而散之,既“益火之源”促阳化气,又散结祛邪“以消阴翳”,温阳扶正与散结祛邪并举,温散相因,攻补兼施,疏肝理脾,多法并用。本文基于《黄帝内经》“阳化气,阴成形”理论,就甲状腺结节辨治进行探讨,以期进一步丰富中医论治甲状腺结节病机理论。

It is believed that the thyroid nodules are tangible entities,so we put forward the thoughts of yang deficiency and yin stagnation contributing to the fundamental pathogenesis of thyroid nodules.Yang deficiency is the root and yin stagnation is the key.The disease is induced by the depletion of yang qi failing to transform and transport the blood,fluids,essence and others,and finally caused by the accumulated pathogenic phlegm-rheum,toxin and static turbidity.For treatment,it is suggested to warm yang to facilitate qi transformation and root protection,and to additionally select from the methods of invigorating the spleen,dispersing the stagnated liver-energy based on the abnormal exuberance of yin or yang,all of which can gradually dissipate nodules.Based on the theory of“yang transforming into qi while yin responsible for the configuration”which was recorded in the Huang Di Nei Jing,this article discussed the diagnosis and treatment of thyroid nodules in order to further enrich the theory of pathogenesis of thyroid nodules in TCM.