王志刚教授从肝论治甲状腺功能亢进症经验整理

Professor WANG Zhigang’s experience in treating hyperthyroidism from the perspective of liver

甲状腺功能亢进症(简称甲亢)临床以心悸、汗出、饮食增多、行大便次数明细增多以及体质量减轻为主要症状,多数还伴有眼突、水肿、视力减退症状。中医诊断初期可见肝郁气滞,中期可见肝火旺盛,久病则可见气阴两虚,甚则脾肾阳虚和阴阳两虚。其发病的原因有内外两种因素,内因主要为情志不畅、肝气郁滞从而内伤积聚以致肝脾气逆,脏腑功能失和。外因主要与生活环境、水质、饮水或食物中含碘不足、家族遗传史等有关。主要病理机制为甲状腺分泌激素过多导致机体兴奋增高和代谢亢进,属中医学中“瘿病”范畴。临床症状为患者颈部肿大、肿块,此病曾经在中国早期偏远地区发病较多,俗称“大脖子病”。随着生活水平提高,社会压力加大,环境变化等影响,甲亢症患病率有所增加。甘肃中医药大学王志刚教授致力于临床研究甲亢症30余年,并根据多年临床经验总结出“从肝论治”的相关治疗思路。通过疏肝理气、清肝降火、柔肝养阴的方法治疗,取得较好临床疗效。文章通过对王志刚教授从肝论治甲亢症的诊疗经验进行简要整理,旨在为临床治疗甲亢症提供新思路。

The clinical symptoms of hyperthyroidism are palpitations,sweating,increased diet,increased stool frequency and body weight loss,and most of them are accompanied by ocular protrusion,edema,and vision loss.In the early stage of TCM diagnosis,liver depression and Qi(气)stagnation can be seen,liver fire can be seen in the middle stage,and long-term illness can be seen as Qi and Yin(阴)deficiency,and even spleen and kidney Yang(阳)deficiency and Yin and Yang deficiency.The causes of its onset are internal and external factors,mainly due to poor mood,stagnation of liver Qi,resulting in the accumulation of internal injuries,resulting in liver and spleen Qi reversal,and organ dysfunction.The external causes of this disease are mainly related to the living environment,water quality,insufficient iodine in drinking water or food,and family genetic history.The main pathological mechanism is excessive secretion of thyroid hormones leading to increased excitation and hypermetabolism of the body,which belongs to the category of the Ying disease(瘿病)in TCM.The clinical symptoms are swollen neck and lumps,which used to occur more often in remote areas of early China,commonly known as big neck disease.With the improvement of living standards,increased social pressure,environmental changes and other effects,the prevalence of hyperthyroidism has increased.Professor WANG Zhigang of Gansu University of Chinese Medicine has been committed to clinical research on hyperthyroidism for more than 30 years,and has summarized the relevant treatment ideas of treating from the liver based on years of clinical experience.Through the treatment of liver thinning and Qi,clearing the liver and reducing fire,and softening the liver and nourishing Yin,good clinical efficacy has been achieved.This paper briefly summarizes Professor WANG Zhigang's diagnosis and treatment experience in the treatment of hyperthyroidism from the liver,aiming to provide new ideas for the clinical treatment of hyperthyroidism.