王志刚主任从“肝火旺盛”论治亚急性甲状腺炎经验

The Director WANG Zhigang’s experience in treating subacute thyroiditis from the aspect of the strong liver-fire

亚急性甲状腺炎(简称亚甲炎)是由感染病毒体所引起的一种自限性甲状腺局部炎症。此病多见于中青年女性,临床表现为发热、咽痛、甲状腺部位疼痛,少数患者经治疗后可遗留甲状腺功能减退症。近年来,随着生活环境、情志因素等改变,亚甲炎发病率逐年上升,病情变化复杂,且易复发。中医学治疗瘿病,多以清肝泻火、消瘿散结、活血解毒等为治则治法,方药多选栀子清肝汤、海藻玉壶汤、消瘰丸等。王志刚主任医师根据患者不同的临床表现和病程进展,准确分析证型,辨证论治,以调整肝脏功能为本,以消瘿散结为标,标本同治,从“肝火旺盛”角度治疗,佐以燥湿、祛痰、平肝、潜阳、健脾等法,辨证准确,选方恰当,用药精炼,疗效显著,充分发挥了中医药的优势。文章通过案例,介绍王主任治疗亚甲炎的成功经验,以期供临床参考。

Subacute thyroiditis is a kind of self-limited thyroid local inflammation caused by infection with a virus.This disease is more common in young and middle-aged woman,its clinical manifestations are fever,sore throat,pain in the thyroid area.A small number of patients after treatment can be left hypothyroidism.In recent years,with the changes of living environment,emotional factors and so on,the incidence of subacute thyroiditis has increased year by year.The disease is easy to relapse,and the clinical changes is complex.Chief Physician TCM treats galls,mostly to clear the liver and diarrhea fire,eliminate galls and disperse knots,activate blood and detoxify as the treatment methods,and choose the Zhizi Qinggan decoction(栀子清肝汤),the Haizao Yuhu decoction(海藻玉壶汤),Xiaoluo Wan(消瘰丸),etc..Chief physician WANG Zhigang according to the different clinical manifestations and disease progression of patients,accurate analysis of the symptom type,differentiation and treatment,based on adjusting liver function,taking the elimination of galls and dispersion as the target,treating the specimen and the root cause,treating from the perspective of liver fire,accompanied by dryness,expectorant,flat liver,QianYang(潜阳),spleen strengthening and other methods,accurate differentiation,appropriate selection,medicine refining,significant curative effect,giving full play to the advantages of TCM medicine.In this article,the successful experience of Director WANG in the treatment of subacute thyroiditis is introduced by empirical case analysis,hoping to provide a clinical reference.