何泽教授从火论治早中期甲状腺功能亢进症之临床经验浅析

Professor HE Ze's clinical experience in treating hyperthyroidism in early and middle stage from the perspective of fire

甲状腺功能亢进症(简称甲亢)是以血液循环中甲状腺激素水平增加、作用增强为特征的一种临床综合征,为内分泌系统的常见病、多发病。此病以神经、循环、消化等系统兴奋性增高和代谢亢进为主要表现,典型的临床表现包括甲状腺毒症、弥漫性甲状腺肿,还可能有心悸、出汗、体质量减轻、手抖、易激动以及眼球突出等症状。甲亢属于中医“瘿病”范畴,其发病与水土环境、情志失调、体质因素、自身免疫等因素相关。当前西医治疗甲亢的主要方法有药物、放射碘和手术,具有一定的效果,但是总体疗效不尽如人意。中医针对甲亢采用辨证论治,能够提高疗效,极大地改善患者的临床症状,缩短药物的使用疗程,提高患者的依从性。长春中医院大学附属医院何泽教授基于中医理论以及丰富的临床经验,认为火邪在早中期瘿病中扮演着至关重要的角色,气、瘀、痰是重要的致病因素。瘿病患者初期多表现为心烦易怒、焦虑等情绪异常,符合失常之气致火的描述。何教授认同朱震亨(号丹溪)“气有余便是火”的理论,强调火邪与早中期瘿病的关系,常从火论治,喜用对药。文章结合案例介绍何教授从火治疗甲亢的成功经验,以期为临床提供参考。

Hyperthyroidism is a clinical syndrome characterized by increased thyroid hormone levels and enhanced effects on the blood circulation,is a common and frequently occurring disease of the endocrine system.The main manifestations of this disease are increased excitability of nervous,circulatory and digestive systems,and hypermetabolism.The typical clinical manifestations include thyrotoxicosis,diffuse goiter,and may include palpitations,sweating,weight loss,shaking hands,irritability,exophthalmia and so on.Hyperthyroidism belongs to the category of the Ying disease(瘿病)in TCM,and its incidence is closely related to external environment,emotional imbalance and physical factors autoimmune and other factors.At present,the main methods of Western medicine for hyperthyroidism include medicine,radioactive iodine and surgery,which have certain effects,but the overall effect is not satisfactory.TCM treatment of hyperthyroidism based on syndrome differentiation can improve the curative effect,greatly ameliorate the clinical symptoms of patients,shorten the course of medication,and improve the compliance of patients.Professor HE Ze,from Affiliated Hospital of Changchun University of Traditional Chinese Medicine,based on TCM theory and rich clinical experience,believes that fire pathogen plays a crucial role in the early and middle stages of the Ying disease,and that Qi(气),blood stasis and phlegm are important pathogenic factors.In the initial stage,the patients with the Ying disease mostly show upset,irritable,anxious and other emotional abnormalities,which is consistent with the description of fire caused by abnormal Qi.Professor HE agrees with the theory of excessive Qi causing fire of ZHU Zhenheng,a famous medical scientist of Yuan Dynasty,and emphasizes the relationship between fire pathogen and early and middle stage the Ying disease.He often treated the disease from the perspective of fire,and preferred to use paired medicines.In this paper,Professor HE’s successful experience in treating hyperthyroidism from the perspective of fire is introduced,with a view to providing a reference for clinical practice.