| 冯倩,裴瑞霞.裴瑞霞从肝论治亚临床甲减经验[J].浙江中医药大学学报,2020,44(10):956-959. |
| 裴瑞霞从肝论治亚临床甲减经验 |
| PEI Ruixia’s Experience in Treating Subclinical Hypothyroidism from Liver |
| DOI：10-16466/j.issn1005-5509-2020-10-006 |
| 中文关键词: 亚临床甲减 从肝论治 肝郁 辨证论治 裴瑞霞 名医经验 验案 |
| 英文关键词: subclinical hypothyroidism treat from liveri depressed liver syndrome differentiation and treatment PEI Ruixia famous doctor’s experience medical cases |
| 基金项目:高上林全国名中医传承工作室建设项目(国中医药人教发[2011]41号)；陕西省第三届名中医裴瑞霞传承工作室建设项目(陕中医药发[2019]036号) |
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| 中文摘要: |
| [目的]总结裴瑞霞教授从肝论治亚临床甲减的辨治思想和选方用药经验。[方法]通过跟随裴瑞霞教授门诊，收集裴教授治疗亚临床甲减的典型医案，并对其进行整理、分析、总结，从病因病机、选方用药等方面论述裴教授从肝论治亚临床甲减的学术思想及临床诊疗思路，并附典型验案两则加以佐证。[结果]裴教授常以肝为着眼点辨证论治亚临床甲减，根据多年临床经验认为亚临床甲减的发生多受情志因素影响，其病机与肝郁密切相关，气机郁滞、气血津液运行失常、痰瘀互结为本病病理基础，并将其分为肝郁气结、痰气阻滞证，肝郁脾虚、痰湿蕴结证，肝郁血瘀、痰瘀互结证，肝郁日久、气阴亏虚证等4个证型进行辨证论治，常常可取得良好的临床疗效。所举验案一为肝郁脾虚型，治疗当以疏肝解郁、健脾和中为基本原则，方选逍遥散加减；验案二为气阴两虚型，治疗当以益气养阴为基本原则，方选小柴胡汤合生脉散加减，治疗后均获得显著疗效。[结论]裴瑞霞教授从肝论治亚临床甲减，紧扣病机，并结合患者临床症状及体征，整体辨证论治，疗效显著，值得推广及学习借鉴。 |
| 英文摘要: |
| [Objective]To summarize Professor PEI Ruixia’s thoughts in syndrome differentiation and treatment of subclinical hypothyroidism from liver and the experience in prescription selection. [Methods]Through following Professor PEI Ruixia’s outpatient clinic work， collecting and sorting out the typical medical cases of subclinical hypothyroidism， Professor PEI’s academic thoughts and clinical thinking of diagnosis and treatment of subclinical hypothyroidism were analyzed and discussed from the aspects of etiology， pathogenesis， prescription and medication selection. And two typical cases were presented as proof. [Results]Professor PEI often treats subclinical hypothyroidism on the basis of liver syndrome differentiation. According to many years of clinical experience， Professor PEI regards the occurrence of subclinical hypothyroidism is mostly affected by emotional factors. The pathogenesis is closely related to liver depression， and its pathological basis is stagnation of Qi and blood， dysfunction of Qi circulation， abnormal operation of blood and body fluid， and combination of phlegm and blood stasis. It can be divided into four syndrome types for syndrome differentiation and treatment， such as liver depression and Qi stagnation， phlegm and Qi stagnation syndrome， liver depression and spleen deficiency， phlegm and dampness accumulation syndrome， liver depression and blood stasis， phlegm and blood stasis syndrome， liver depression for a long time， combined with deficiency of Qi and Yin syndrome， and often obtains good curative effect. Case one was liver depression and spleen deficiency syndrome， so the treatment should base on the basic principle of soothing the liver and relieving depression， strengthening the spleen and harmonizing the stomach， and modified Xiaoyao powder was adopted; case two was Qi and Yin deficiency syndrome， so the treatment should base on replenishing Qi and nourishing Yin， and Xiaochaihu decoction combined with Shengmai powder was adopted. Both of them achieved significant effect in clinic. [Conclusion]Professor PEI Ruixia treats subclinical hypothyroidism from liver， closely related to pathogenesis， combined with clinical symptoms and signs of patients， syndrome differentiation and treatment from the whole， the curative effect is significant， which is worthy of promotion and learning. |
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