张兰教授从肝脾论治桥本甲状腺炎亚临床期

发布时间：2018-05-25 23:21

本文选题：桥本甲状腺炎 + 亚临床期　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：桥本甲状腺炎(Hashimoto thyroiditis,HT),又叫慢性淋巴细胞性甲状腺炎(Chronic Lymphocytic Thyroiditis,CLT),是一种临床上常见的器官特异性自身免疫疾病,是自身免疫性甲状腺疾病(Auto Immuno Thyroiditis Disease,AITD)的一个类型。其主要特点是特异性甲状腺自身抗体甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)的增高和甲状腺内淋巴细胞浸润,最终导致甲状腺组织结构被破坏,造成甲状腺功能低下。现代医学认为其病因主要包括遗传因素、自身免疫因素、环境因素。在治疗上多根据甲功水平对甲亢或甲减进行相应治疗,但对于缩小甲状腺及抑制自身免疫反应,降低抗体水平仍缺乏理想的方法。传统医学认为桥本病的发生主要是情志因素、环境因素及体质因素导致机体脏腑功能失调,痰凝、气滞、血瘀等病理产物搏结于颈前而发病。导师从事内分泌临床工作多年,临床上运用中医特色辨证论治,对桥本病分期治疗,针对亚临床甲功异常,并伴有两项抗体显著升高的亚临床期治疗疗效显著。导师认为亚临床期为疾病初期,情绪因素是此期发生的关键,肝失疏泄,肝郁克脾,脾气亏虚,输津失常,凝聚成痰,痰随气行,无处不到,停于颈前,则见颈前肿大。亚临床甲亢期以肝郁脾虚为重,亚临床甲减期则以脾肾气虚为主。导师分期治疗桥本病亚临床期,以疏肝理气为基础,佐以健脾补肾,并将中医脏腑与现代医学中免疫功能联系起来,治病同时重视与患者情感上的交流与沟通,收效显著。
[Abstract]:Hashimoto thyroiditis, or chronic lymphocytic thyroiditis, is a common organ specific autoimmune disease and a type of autoimmune thyroid disease. Its main characteristics are the increase of specific thyroid autoantibody thyroglobulin antibody (TGAbA) and thyroid peroxidase antibody (TPOAbb) and the infiltration of intrathyroid lymphocytes resulting in the destruction of thyroid tissue structure and the hypothyroidism. Modern medicine thinks its etiology mainly includes heredity factor, autoimmune factor, environment factor. Hyperthyroidism or hypothyroidism were treated according to the level of thyroid work, but there was still no ideal method for reducing thyroid gland, inhibiting autoimmune reaction and reducing antibody level. Traditional medicine believes that Hashimoto's disease is mainly caused by emotional factors, environmental factors and physical factors leading to dysfunction of viscera function, phlegm coagulation, qi stagnation, blood stasis and other pathological products in front of the neck. The tutor engaged in the endocrine clinical work for many years, the clinical use Chinese medicine characteristic differentiation treatment, to Hashimoto disease stage treatment, aimed at the subclinical thyroid dysfunction, and accompanied by two significantly increased antibody subclinical treatment effect is remarkable. The tutor thinks that the subclinical stage is the initial stage of the disease, the emotional factor is the key to the occurrence of this period, the liver is lost, the liver is depressed, the spleen is deficient, the transfusion of Tianjin is abnormal, the sputum is condensed into phlegm, the phlegm follows the Qi, nowhere is less than, stop in the front of the neck, see the neck before swelling. In the subclinical hyperthyroidism stage, liver stagnation and spleen deficiency were the most important, while the subclinical hypothyroidism was mainly spleen and kidney qi deficiency. The teacher treated Hashimoto's disease by stages in subclinical stage, based on soothing liver and regulating qi, adding spleen and tonifying kidney, connecting the viscera of traditional Chinese medicine with immunological function in modern medicine, paying attention to the communication and communication with patients' emotion, and achieving remarkable results.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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