基于络病理论从络息成积辨析甲状腺结节病机

Discussion on Pathogenesis of Thyroid Nodules from the Perspective of Masses Obstruction of Collaterals Based on Collateral Disease Theory

络病理论是中医学重要的病机学说,而“络息成积”是络病主要病机之一。根据甲状腺结节病机特点,病程演变等可将其归属为中医学“络病”范畴,从络病理论认识甲状腺结节。从络息成积探析甲状腺结节病机,提出络气郁滞是结节发病的始动因素;气、痰、瘀搏结阻络是结节形成的病机关键;毒损络脉、正气虚耗是甲状腺结节向癌转变的重要因素。治疗以祛邪通络为治则,以疏肝理气、化痰软坚等为治法,多法合用,辨证施治。从络病角度为临床治疗甲状腺结节提供新的诊疗思路。

Collateral disease theory is an important pathogenesis theory in traditional Chinese medicine(TCM).“Masses obstruction of collaterals”is one of the chief pathogenesis of collateral diseases.According to the pathogenesis characteristics and course of the disease,thyroid nodules are classified into collateral diseases of TCM and can be studied based on collateral disease theory.This paper explores the pathogenesis of thyroid nodules from the perspective of masses obstruction of collaterals and proposes that collateral-qi stagnation is the initiating factor of the thyroid nodule.In addition,obstruction of collaterals by qi,phlegm,and stasis is the key pathogenesis of nodule formation,and toxic damage of collaterals and depletion of vital qi are the important factors promoting the transformation of the thyroid nodule to cancer.Therefore,clinical treatment should follow the principle of removing pathogens and dredging collaterals and take soothing the liver,regulating qi,dissipating phlegm,and resolving hard masses as the therapeutic method.It is also necessary to combine multiple methods and treat the disease by syndromes,so as to provide new ideas for clinically diagnosing and treating thyroid nodules from the perspective of collateral diseases.