摘要
中医理论认为甲状腺结节(thyroid nodule,TN)按照其临床症状主要归属于“瘿病”“瘿瘤”范畴。在TN的成因上,历代医家的理论探究及现代临床研究结果皆表明肝气郁结是不可忽视的重要致病因素。从脏腑角度而言,TN的病理基础为肝气郁滞;从经络角度而论,TN的潜在发病机制为肝经郁滞;从病证相合的辨治角度来看,肝气郁结作为TN的核心病机贯穿病程始终。“肝体阴用阳”出自《临证指南医案·肝风篇》,是以中医基础理论中脏腑及阴阳理论为指导,嫁接中国古代哲学中“体用”概念而成的,用以阐释肝脏体藏阴血与用司疏泄不可分割的生理特性的学术思想。因此,基于以上结论,结合中医“治病求本”的思想及历代名家治肝心得,笔者提出了从疏肝解郁论治TN的观点,并根据肝脏体阴用阳的生理特性,提出了以调肝用及护肝体为原则的气血并重、脏腑经络兼治、虚实兼顾的疏肝解郁新治法,以期为临床防治TN提供参考。
According to the theory of traditional Chinese medicine(TCM)theory,thyroid nodule(TN)is mainly classified into the category of“goiter”and“goiter tumor”according to its clinical symptoms.In terms of the cause of TN,both the theoretical research of medical experts in the past dynasties and the results of modern clinical studies show that Liver-Qi Stasis is an important pathogenic factor that cannot be ignored.From the perspective of viscera,the pathological basis of TN is liver Qi stagnation.From the perspective of meridians,the potential pathogenesis of TN is liver meridians stagnation.From the perspective of combination of disease differentiation and syndrome differentiation,Liver-Qi Stasis as the core pathogenesis of TN through the whole progress of the disease.“Liver body Yin uses Yang”is derived from the“Medical Cases of Clinical Syndrome Guide·Liver Wind”,which is based on the basic theories of Zang-Fu organs and Yin-Yang as the guidance,and grafted with the concept of“body use”in ancient Chinese philosophy,to explain the academic thought of the inseparable physiological characteristics of the liver body storing Yin and blood and the use of department to relieve.Base on the above conclusion,combined with TCM of the thought of“curing diseases and seeking the root”and the liver experience that all previous dynasties famous people treated.According to the physiological characteristics of liver body,the author puts forward a new treatment method of relieving depression and soothing liver,which is based on the principle of regulating and protecting the function and body of liver,focusing on both Qi and blood,treating both viscera and channels,and giving consideration to deficiency and actual condition.This thesis may provide reference for clinical prevention and treatment of TN.
作者
陈金凤
温乔
严清萍
周围
娄锡恩
CHEN Jinfeng;WEN Qiao;YAN Qingping;ZHOU Wei;LOU Xi’en(The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《环球中医药》
CAS
2021年第9期1587-1592,共6页
Global Traditional Chinese Medicine
关键词
甲状腺结节
瘿病
瘿瘤
疏肝解郁
肝体阴用阳
病证相合
治肝
Thyroid nodule
Gall disease
Gall
Soothing liver-Qi stagnation
Liver body Yin uses Yang
Combination of disease differentiation and syndrome differentiation
Treatment of liver disease