基于内毒理论辨治亚急性甲状腺炎反复发作经验

Experience in Treatment of Recurrent Subacute Thyroiditis Based on the Theory of Internal Toxin

介绍基于内毒理论辨治亚急性甲状腺炎(简称亚甲炎)反复发作的临证经验。认为内毒蓄积为亚甲炎反复发作的核心病机,脾虚为成毒的根本原因,脾失健运,生浊内蕴,酿生本原之毒;火、湿、毒互结为病机关键,湿浊蕴积日久酿生痰、火、瘀,邪气久积化为附生之毒。临床见火湿毒较重者,治以疏肝健脾、水火分治,方以自拟柴胡解毒饮加减;脾虚毒恋者,治以健脾化浊、断其毒源,方以自拟十味白术散加减;阳虚毒滞者,解毒不忘温阳,治以和阳益血托毒,方以自拟和阳败毒散加减。

This paper summarized clinical experience of treating recurrent subacute thyroiditis based on the theory of internal toxin.It is believed that the core pathogenesis of recurrent subacute thyroiditis is the accumulation of internal toxin.The dysfunction of the spleen in transportation leads to the internal retention of turbidity,which serves as the basis for the formation of toxins.The combination of fire,dampness,and toxins is the key to the disease mechanism.Prolonged accumulation of dampness and turbidity leads to the formation of phlegm,fire,and stasis,and prolonged accumulation of pathogenic factors transforms into secondary toxins.For patients with severe fire,dampness,and toxins,the treatment focuses on dispersing stagnated liver qi,invigorating spleen,and differentiation treatment of fire and water,using a self-designed Chaihu Jiedu Decoction(柴胡解毒饮).For patients with spleen deficiency and toxin accumulation,the treatment focuses on invigorating the spleen,eliminating turbidity,and cutting off the source of toxins,using a self-designed Shiwei Baizhu Powder(十味白术散).For patients with yang deficiency and toxin stagnation,detoxification is combined with warming yang,nourishing blood,and supporting toxin expulsion,using a self-designed Heyang Baidu powder(和阳败毒散).