邵迎新教授从气虚辨治甲状腺结节的经验

Professor Shao Yingxin’s experience in treating thyroid nodules is differentiated from qi deficiency

中国成年人甲状腺结节的患病率高达20%,西医主要是采取手术治疗和随访观察。中医称甲状腺结节为瘿瘤,一般从肝脾论治,认为是由于情志内伤引起肝失条达,或饮食失宜引起脾失健运,进而导致气滞、痰凝、血瘀,壅结颈前而为瘿瘤,治以理气活血,化痰消瘿。邵迎新教授认为本病的病因主要是先天禀赋不足即胎传,和/或后天饮食中碘的摄入不当,与情志相关但非主因。因先天不足或后天失调导致气虚,气虚推动无力使气血津液运行不畅,导致气痰瘀三者合而为患,积结颈前而发病。其基本病机是气虚生积、痰结血瘀,病机关键为气虚,由气虚导致气滞、痰凝、血瘀,日久痰瘀积结,形成瘿瘤。基本证型为正气亏虚、痰结血瘀证,治以益气化瘀,祛痰散结。临床证实从气虚辨治瘿瘤效果满意,为治疗甲状腺结节提供了新的思路,值得借鉴应用。

The prevalence of thyroid nodules in Chinese adults is as high as 20%,western medicine mainly adopts surgical treatment and follow-up observation.Thyroid nodules are called gall tumor in traditional Chinese medicine.It is generally treated from the liver and spleen.It is considered that the liver is out of order due to emotional trauma,or the spleen is out of health and transportation due to improper diet,which leads to qi stagnation,phlegm coagulation and blood stasis,and obstructs the neck.The gall is treated by regulating qi and activating blood,resolving phlegm and eliminating gall.Professor Shao Yingxin believes that the main cause of this disease is congenital deficiency,namely fetal transmission,or(and)improper intake of iodine in the diet,and emotional but not the main cause.Due to congenital deficiency or acquired disorders caused by qi deficiency,qi deficiency can not promote the movement of qi,blood and body fluid is not smooth,resulting in the combination of qi,phlegm and blood stasis,the neck and the disease.The basic pathogenesis is qi deficiency,accumulation of phlegm and blood stasis,and the key pathogenesis is qi deficiency.Qi deficiency leads to qi stagnation,phlegm coagulation,blood stasis,and accumulation of phlegm and blood stasis,forming gall tumors.The basic syndrome type is deficiency of vital qi,phlegm and blood stasis syndrome.The treatment is tonifying qi and removing blood stasis,eliminating phlegm and dispersing stagnation.Clinically,it is proved that the treatment of gall tumors based on qi deficiency is satisfactory,which provides a new idea for the treatment of thyroid nodules and is worthy of reference and application.