基于“亢害承制”刍议含富碘中药类方在Graves病治疗中的应用

Discussion on the application of iodine-rich Chinese medicine prescriptions in the treatment of Graves’disease based on the theory of‘restraining excessiveness to acquire harmony’

“亢害承制”是《黄帝内经》五运六气学说中的经典理论,原意指五运六气变化过程中的自我稳态调控机制,后世医家结合自身观点和临证实践不断丰富其理论内涵,用以解释人体生理和病理规律,指导遣方用药。Graves病(GD)的发病即“亢害败乱,承之不及”的过程,肝火鸱张,亢极无制,伺肝脉上炎,甲状腺激素合成增多;火热煎熬肝阴,炼液成痰,壅结颈前,使GD缠绵难愈。在“亢害承制”理论指导下,海藻、昆布等富碘中药禀受海洋咸寒之气,平抑肝火之亢,行软坚化痰之功,涵养人体造化之枢。文章以“亢害承制”理论为切入点,探析含富碘中药类方在GD中的应用,以期进一步拓展其治疗GD的理论外延。

The‘restraining excessiveness to acquire harmony’theory is a classic theory of five evolutive phases and six climatic factors in Huangdi Neijing,which originally referred to the self-balance regulatory mechanism in the transforming process of five evolutive phases and six climatic factors.Later generations had enriched its theoretical connotation by combining their own views and clinical practice,so as to explain the physiological and pathological laws of human body and instructed the prescriptions to be administered.The onset of Graves’disease(GD)is the process of‘the hyperactive one becoming harmful and the predominant one failing to restrict’,due to the flaring up of exuberant liver fire followed the liver meridian without restriction,and finally increased synthesis of thyroid hormone.The liver yin was tormented by fire-fheat pathogens,condensed liquid into phlegm,which blocked in the front of the neck,making GD difficult to cure.Under the guidance of the theory of‘restraining excessiveness to acquire harmony’,the iodine-rich Chinese medicine such as seaweed and Kunbu could allay the overactivity of the liver fire,soften hardness and eliminate phlegm as well as nourish the pivot of human nature with its character of salty and cold endowed by ocean.In this paper,the theory of‘restraining excessiveness to acquire harmony’was taken as the breakthrough point to explore the application of iodine-rich Chinese medicine prescriptions in the treatment of GD,aim to further expand its theoretical extension.