杜丽坤，李新梦

（1.黑龙江中医药大学附属第一医院， 哈尔滨 150040；2.黑龙江中医药大学， 哈尔滨 150040）

疏风解毒法治疗亚急性甲状腺炎

杜丽坤1，李新梦2

（1.黑龙江中医药大学附属第一医院， 哈尔滨 150040；2.黑龙江中医药大学， 哈尔滨 150040）

中医认为，亚急性甲状腺炎其发病机制包括外感和内伤两个方面，大多是由于外感风温邪热，热毒壅盛，灼伤津液，炼液为痰，痰阻气机，郁而化热，最终导致气血痰热壅结于颈前，病变脏腑多涉及肺、脾、肝。临床根据病程的长短及兼症情况，将其分为3期：初期、中期、晚期，初期应以疏风清热、解毒利咽消肿为主，中期应更侧重于疏肝理气、化痰散结，后期则以滋阴清热、化痰散结为主。通过给予初期亚急性甲状腺炎患者单纯中药汤剂口服，针对症状缓解程度、毒副作用及预后等进行综合分析，体现出了疏风解毒法在亚急性甲状腺炎治疗中的重要性，为本病的治疗提供了依据。

亚急性甲状腺炎；疏风解毒；中医药疗法

Abstract: Subacute thyroiditis belongs to the Chinese medicine “gall disease” category, Chinese medicine believes that the pathogenesis of subacute thyroiditis includes external contraction and internal damage.Externalcontraction fever and warm disease, heat toxin, fluid exhaustion, turbid phlegm obstructing lung, depression resulting in accumulation of phlegm and heat in the neck and it turns into zang-fu organs syndrome differentiation which causes subacute thyroiditis.According to the length of the course of the disease and the situation, treatment will be divided into three periods： early, medium and later period the initial should disperse wind and remove heat and toxin, edemaalleviating mainly in the medium period should focus more on liver qi, resolving phlegm and dissipating mass.In the later period, nourishing yin and clearing away fire and resolving phlegm and dissipating mass are the points.In this study, the importance of the method of phlegm detoxification in the treatment of subacute thyroiditis was analyzed by analyzing the degree of remission, side-effects and prognosis of patients with subacute thyroiditis.The method shows the importance of dispersing wind and removing toxin and gives a guidance to the treatment.

Keywords: subacute thyroiditis; dispersing wind and removing toxin; traditional Chinese medicine

亚急性甲状腺炎，也称为肉芽肿性甲状腺炎、巨细胞性甲状腺炎、De Quervain甲状腺，是一种自限性的非化脓性甲状腺疾病，与病毒感染密切相关，包括腺病毒、流感病毒、柯萨奇病毒、腮腺炎病毒[1]。本病在甲状腺疾病中约占5%[2]，男性和女性的发病率比例约为1：3～6，以 40 ～ 50岁的女性最为常见[3]。因为早期症状不典型，容易误诊和漏诊[4-5]。西医多使用糖皮质激素和非甾体类抗炎药物治疗[6]，虽疗效迅速，但不良反应较大，易复发[7-8]。中医采用疏风解毒法治疗本病具有明显优势，报道如下。……