从《理虚元鉴》“伏火”理论谈甲状腺癌术后TSH抑制治疗诸证辨治

Mechanism discussion on the treatment of syndromes after postoperative TSH suppression therapy for thyroid cancer based on the theory of“latent fire”in Lixu Yuanjian

甲状腺癌患者在术后通常需进行促甲状腺激素(TSH)抑制治疗,通过抑制激素的分泌,起到控制肿瘤复发转移的作用。但TSH抑制可出现亚临床甲亢,产生心慌、疲劳、失眠、烦躁、骨质疏松或关节疼痛等诸多症状。《理虚元鉴》“伏火”理论认为,伏火为“先动于气,久而渐着于形”,与术后TSH抑制治疗诸证的发生密切相关。本文旨基于《理虚元鉴》“伏火”理论探讨甲状腺癌术后TSH抑制治疗诸证的病机特点及诊疗思路。

Thyroid cancer patients usually need to undergo thyroid hormone(TSH)suppression therapy after surgery,which can control tumor recurrence and metastasis by inhibiting hormone secretion.However,TSH suppression can lead to subclinical hyperthyroidism,resulting in panic,fatigue,insomnia,irritability,osteoporosis or joint pain and many other symptoms.According to the theory of“latent fire”in Lixu Yuanjian,latent fire“moves first in the pneuma,and gradually in the form over time”,this is closely related to the occurrence of postoperative TSH suppression treatment.Therefore,based on the theory of“latent fire”in Lixu Yuanjian,this article aims to discuss the pathogenesis,diagnosis and treatment of syndromes after postoperative TSH suppression therapy for thyroid cancer.