摘要
甲状腺功能亢进症(简称甲亢)是一种临床常见病、多发病。现代医学治疗甲亢的方案主要是口服甲巯咪唑片、放射性碘治疗和手术治疗,上述3种方法不良反应较多,后期容易出现甲状腺功能减退。刘树民教授从事内科杂病治疗30余年,擅长运用中医辨证思维治疗各种疑难杂症。他认为,甲亢的病因隐匿且复杂,其基本病机为本虚标实。本虚以气阴两虚为主;标实以肝郁气滞较为常见。研究从病因病机、临床特征、治疗等方面系统分析、总结了刘树民教授运用芪玄抑甲宁为基础方治疗甲亢气阴两虚证的临证经验。建议在辨证治疗时注意以下5个要点:第一,注重疏理肝之郁气。肝气郁结是标实的主要外在表现,理气调肝为其治疗大法。第二,注重肝与心对调节情志的协同之功。肝藏血与心主血、肝藏魂与心藏神乃调节情绪、情志,维持精神、思维愉悦的关键,临证时应肝、心同调,以求情志畅达。第三,注重肝与肾的子母生化关系。肾、肝为母子之脏,肾水涵木,肾阴可滋生肝阴,以制约肝阳。第四,注重肝与脾的关系。肝和脾属五行相克,但相克太过即出现肝木乘脾土的情况,应注重肝脾之生克以求木土之平衡。第五,注意饮食。避免进食辛辣之品以防耗伤阴津及削弱中药滋阴之效。
The main treatment options for hyperthyroidism in modern medicine are oral methimazole tablets, radioactive iodine therapy, and surgical treatment. All three methods have more adverse reactions and are prone to hypothyroidism in the later stage. Professor LIU Shumin has been engaged in the treatment of various internal medicine diseases for over thirty years. He is skilled in using the differentiation thinking of traditional Chinese medicine to treat various difficult and complex diseases. He considers that the etiology of hyperthyroidism is hidden and often influenced multiple factors. The basic pathogenesis of hyperthyroidism is the deficiency of Qi(气) and Yin(阴), with deficiency of both Qi and Yin as the main symptoms, and liver stagnation and Qi stagnation as the main symptoms. This article systematically analyzes and summarizes Professor LIU Shumin's clinical experience in using Qixuan Yijia Ning(芪玄抑甲宁) as the basic prescription to treat hyperthyroidism with Qi and Yin deficiency syndrome from the aspects of etiology, pathogenesis, clinical characteristics, treatment and other aspects. The following five key points need to be paid attention to when treating hyperthyroidism with syndrome differentiation: First, it is important to focus on regulating the stagnation of liver Qi. Liver Qi stagnation is the main external manifestation, and regulating Qi and harmonizing the liver should be the main treatment method. Second, attention should be paid to the synergistic function of the liver and heart in regulating emotions. The liver stores blood, and the heart governs blood. The liver stores the ethereal soul, and the heart stores the spirit, which regulate emotions and maintain a pleasant mental state. In clinical practice, the liver and heart should be harmonized to achieve smooth emotional expression. Third, attention should be paid to the motherchild relationship between the liver and kidneys in terms of biochemical processes. The kidneys and liver are considered mother and child organs. The kidneys nourish the liver Yin and restrain the liver Yang. Fourth, attention should be paid to the relationship between the liver and spleen. The liver and spleen belong to the five elements that counteract each other. However, excessive counteraction can lead to the situation where the liver wood overacts on the spleen earth. Therefore, it is important to focus on the mutual generation and control between the liver and spleen to achieve a balance between wood and earth. Fifth, attention should be paid to diet. Avoiding spicy foods can prevent the consumption of Yin fluids and weaken the nourishing effect of herbal medicine on Yin.
出处
《中医临床研究》
2024年第22期77-80,共4页
Clinical Journal Of Chinese Medicine
基金
黑龙江省第二批省级名中医师承工作项目(黑中医药发[2020]55号)
黑龙江中医药大学领军人才课题(2018RCL13)。
关键词
甲状腺功能亢进症
气阴两虚证
芪玄抑甲宁
名医经验
Hyperthyroidism
Deficiency of Qi and Yin syndrome
Qixuan Yijia Ning
Famous doctor experience
