吴敏教授从“土壅木郁,痰瘀互结”分型辨证治疗甲状腺结节经验精粹

Professor Wu Min's Experience in Treating Thyroid Nodules Based on Differentiation of Syndromes of Earth Stagnation and Wood Depression and Phlegm Combined with Stasis

甲状腺结节(Thyroid nodule,TN)是临床常见病、多发病。吴敏教授依据临床多年实践经验,认为TN多与情志失调有关,病位涉及肝脾,气滞、痰凝、血瘀为TN主要病理因素,提出“土壅木郁、痰瘀互结”是其核心病机,并将西医的病理分型与中医证型相结合,分型辨证治疗TN,将中西医融会贯通,治疗上以疏肝理气为先,不离健脾助运之法,化痰散结,活血消瘿,对良性TN可以有效缩小甲状腺肿,减轻症状,对于恶性TN可以降低术后复发率,减少西药不良反应等。此外,吴敏教授倡导“防大于治”,临床实践中尤注重中医预防调摄,效果显著。

Thyroid nodules represent a common and frequent disease in clinical practice.With years of clinical experience,Professor Wu Min believes that this disease is primarily associated with emotional disorders.This disease primarily involves the liver and spleen,with qi stagnation,phlegm coagulation,and blood stasis as the main pathological factors,and earth stagnation and wood depression and phlegm combined with stasis as the core pathological mechanisms.Professor Wu combines the pathological typing of Western medicine with the syndrome differentiation of traditional Chinese medicine to diagnose and treat thyroid nodules.Accordingly,Professor Wu proposes the treatment principles of soothing liver,regulating qi movement,and invigorating spleen for transportation,and suggests that the method of resolving phlegm and dissipating mass as well as activating blood and eliminating goiter can be adopted.These methods reduce goiter and alleviate the symptoms in the patients with benign nodules and reduce the rates of postoperative recurrence and adverse reactions caused by Western medicine for malignant nodules.Moreover,Professor Wu advocates prevention before disease onset and emphasizes prevention and regulation with traditional Chinese medicine in clinical practice.