冉颖卓从少阳受邪分期论治亚急性甲状腺炎经验

Professor RAN Yingzhuo’s Experience in Treating Subacute Thyroiditis by Stages from Invasion of Pathogenic Factors into Shaoyang

冉颖卓教授认为亚急性甲状腺炎的病机主要在于少阳枢机不利,应抓住少阳受邪这一根本病机,将本病分为三期进行治疗。初期以邪袭少阳为主,治以和解少阳、清热解毒;中期正邪交争,邪伏少阳,治以和解少阳、解毒利咽;后期正虚而邪退,耗损气阴,治以和解少阳,益气养阴。临床常以小柴胡汤为基本方,注重清热解毒,常使用大青叶、板蓝根、牛蒡子、夏枯草等药物,同时辅以透表泄热之法,常用金银花、连翘、薄荷等药物。

Professor RAN Yingzhuo believes that the pathogenesis of subacute thyroiditis is mainly due to the abnormal performance of shaoyang pivot.Therefore,the treatment of the disease should cathch invasion of pathogenic factors into Shaoyang as fundamental pathogenesis and be divided into three stages.In the early stage,the disease is mainly caused by pathogenic factors attacking Shaoyang and the treatment should be aimed at harmonizing Shaoyang,clearing heat,and removing toxin.In the middle stage,since pathogenic qi is struggling with healthy qi,and the pathogenic factors lurks in Shaoyang,harmonizing Shaoyang,removing toxin,and disinhibiting the throat are suggested to be taken as the treatment.In the later stage,the healthy qi is weak and the pathogenic factors recede,with qi and yin depleted,so the treatment should be aimed at harmonizing Shaoyang,replenishing qi,and nourishing yin.In clinical practice,Xiaochaihu Decoction(小柴胡汤)is the basic prescription.Focusing on clearing heat and removing toxin,drugs such as Daqingye(Polygoin TinctorII Folium),Banlangen(Isatids Radix),Niubangzi(Arci Fructus),and Xiakucao(Prunellae Spica)are often used,supplemented by Jinyinhua(Lonicerae Japonicae Flos),Lianqiao(Forsythia Fructus),Bohe(Menthae Haplocalycis Herba)and other drugs to expel heat from the exterior.