张发荣用膏方治疗甲状腺功能亢进症的临床经验
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摘要
膏方作为中药传统剂型,在慢性病的防治中发挥着重要作用。张发荣教授是首届全国名中医,擅长治疗内分泌疾病,张老认为甲亢发病有体质因素,先天不足与素体阴虚是甲亢的基本病因病机,再加上后天情志不舒,长期抑郁,导致肝气郁结,痰气凝结,郁久化火,耗散气阴,呈现出邪热耗伤气津的高代谢特点。甲亢的治疗应针对病机,治疗原则是益气养阴、疏肝泻火、软坚散结。张老把"辨病"与"辨证"结合,创立了"甲亢膏方",填补了现代甲亢膏方治疗中的空白,取得了很好的临床疗效。
As a traditional Chinese medicine formulation, ointment plays an important role in the prevention and treatment of chronic diseases. Professor ZHANG Fa-rong is the first national famous Chinese medicine, the fifth batch of national experts of traditional Chinese medicine academic experience inheritance work instructor, enjoy the special allowance of the State Council government experts. ZHANG is good at treating endocrine diseases. He believes that the pathogenesis of hyperthyroidism is due to physical factors. Inborn deficiency and deficiency of yin are the basic etiology and pathogenesis of hyperthyroidism. In addition, acquired emotional distress and long-term depression lead to stagnation of liver-qi, coagulation of phlegm-qi, prolonged melting of fire, dissipation of qi-yin, showing the high metabolic characteristics of damaging qi and body by evil heat. The treatment of hyperthyroidism should be based on pathogenesis. The treatment principle is to nourish qi and yin, soothe liver and purge fire, and disperse soft and firm tissues. ZHANG combined ‘disease differentiation' with ‘syndrome differentiation', created ‘hyperthy roidism ointment prescription', filled the blank in the treatment of modern hyperthy roidism ointment prescription, and achieved good clinical efficacy.
As a traditional Chinese medicine formulation, ointment plays an important role in the prevention and treatment of chronic diseases. Professor ZHANG Fa-rong is the first national famous Chinese medicine, the fifth batch of national experts of traditional Chinese medicine academic experience inheritance work instructor, enjoy the special allowance of the State Council government experts. ZHANG is good at treating endocrine diseases. He believes that the pathogenesis of hyperthyroidism is due to physical factors. Inborn deficiency and deficiency of yin are the basic etiology and pathogenesis of hyperthyroidism. In addition, acquired emotional distress and long-term depression lead to stagnation of liver-qi, coagulation of phlegm-qi, prolonged melting of fire, dissipation of qi-yin, showing the high metabolic characteristics of damaging qi and body by evil heat. The treatment of hyperthyroidism should be based on pathogenesis. The treatment principle is to nourish qi and yin, soothe liver and purge fire, and disperse soft and firm tissues. ZHANG combined ‘disease differentiation' with ‘syndrome differentiation', created ‘hyperthy roidism ointment prescription', filled the blank in the treatment of modern hyperthy roidism ointment prescription, and achieved good clinical efficacy.
引文
[1]马宁,崔叶妹,卜振军,等.抗甲亢药物临床应用进展.中国药师,2017,20(3):547-550
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[11]邢晓雪,李玲燕,高慧,等.黄芪甲苷对心脏缺血再灌注损伤的保护作用研究现状.中国临床药理学杂志,2016,32(18):1726-1728
[12]高群.不同益气中药对压力负荷导致小鼠心衰模型钙瞬变干预作用的研究.北京:北京中医药大学,2016
[13]蒋洪强.黄芪甲苷对慢性心力衰竭大鼠心肌CTGF、TGFβ1表达的影响.济南:山东大学,2016
[14]王博雯,张策,高奋堂,等.益气活心丸治疗慢性心力衰竭随机对照临床研究.中华中医药杂志,2018,33(12):5721-5723
[15]陈婷,王天琪,张砚,等.基于整合药理学分析通脉养心丸治疗冠心病心绞痛及心律不齐的分子机制.中华中医药杂志,2018,33(12):5553-5558
[16]郑慧娟,魏璠,魏军平.Graves病发病机制新进展.中国免疫学杂志,2017,33(4):621-624
[17]邵晶,杜丽东,孙政华,等.煎煮形式及配伍比例对党参黄芪复方免疫调节作用的影响.中国临床药理学杂志,2017,33(10):917-920,938
[18]卜红南.黄精多糖的提取及其免疫活性研究.实用医药杂志,2017,34(1):48-51,56
[19]赵俊云,杨向竹,牛欣,等.黄芪糖蛋白对T细胞增殖与活化的影响.中华中医药学刊,2015,33(1):49-50
[20]罗波,尧雪洲,廖敏,等.黄芪甲苷Ⅳ对卵清蛋白诱导的哮喘小鼠CD4+T细胞亚型Th1、Th2免疫活性的抑制作用.中华中医药杂志,2018,33(9):4071-4074
[21]李红玲,苏远,师少军,等.甲巯咪唑药品不良反应病例文献分析.药物流行病学杂志,2017,26(4):259-262
[22]郭昌贵.甲巯咪唑和丙硫氧嘧啶治疗甲亢安全性的回顾性分析.航空航天医学杂志,2017,28(3):340-341
[23]刘子毓.益气生血方治疗甲亢合并白细胞减少症的临床观察.长沙:湖南中医药大学,2015
[24]曾小红.黄芪注射液治疗甲巯咪唑引起甲亢患者白细胞减少症评价.辽宁中医药大学学报,2014,16(12):176-178
[25]王翔宇.黄芪现代药理及临床研究进展.科技风,2017,22(3):182
[26]张建军,胡春玲.中药党参研究的现代进展.甘肃高师学报,2017,22(3):39-43
[27]王慧,袁德培,曾楚华,等.黄精的药理作用及临床应用研究进展.湖北民族学院学报(医学版),2017,34(2):58-60,64
[2]Garmendia Madariaga A,Santos Palacios S,Guillén-Grima F,et al.The incidence and prevalence of thyroid dysfunction in Europe:a meta-analysis.J Clin Endocrinol Metab,2014,99(3):923-931
[3]Hollowell J G,Staehling N W,Flanders W D,et al.Serum TSH,T(4),andthyroidantibodiesintheUnitedStates population(1988 to 1994):National Health and Nutrition Examination Survey(NHANESⅢ).J Clin Endocrinol Metab,2002,87(2):489-499
[4]Shlomo Melmed.Williams Textbook of Endocrinology.12th edition.Philadelphia:Elsevier Inc,2011:366
[5]Alzamani M I.Acute and emergency care for thyrotoxicosis and thyroid storm.Acute Medicine&Surgery,2015,2(3):147-157
[6]朱代玉,杨永碧,李丽.妊娠合并甲亢对母婴代谢指标及预后的影响.中国妇幼保健,2017,32(12):2605-2608
[7]葛均波,徐永健.内科学.北京:人民卫生出版社,2013:685
[8]姚洁敏,邢斌,陈德兴.龙胆泻肝汤类方用药规律初探.上海中医药大学学报,2007,21(1):64-67
[9]Douglas R S,Gupta S.The pathophysiology of thyroid eye disease:implications for immunotherapy.Curr Opin Ophthalmol,2011,22(5):385-390
[10]Stan M N,Garrity J A,Bahn R S.The evaluation and treatment of graves ophthalmopathy.Med Clin North Am,2012,96(2):311-328
[11]邢晓雪,李玲燕,高慧,等.黄芪甲苷对心脏缺血再灌注损伤的保护作用研究现状.中国临床药理学杂志,2016,32(18):1726-1728
[12]高群.不同益气中药对压力负荷导致小鼠心衰模型钙瞬变干预作用的研究.北京:北京中医药大学,2016
[13]蒋洪强.黄芪甲苷对慢性心力衰竭大鼠心肌CTGF、TGFβ1表达的影响.济南:山东大学,2016
[14]王博雯,张策,高奋堂,等.益气活心丸治疗慢性心力衰竭随机对照临床研究.中华中医药杂志,2018,33(12):5721-5723
[15]陈婷,王天琪,张砚,等.基于整合药理学分析通脉养心丸治疗冠心病心绞痛及心律不齐的分子机制.中华中医药杂志,2018,33(12):5553-5558
[16]郑慧娟,魏璠,魏军平.Graves病发病机制新进展.中国免疫学杂志,2017,33(4):621-624
[17]邵晶,杜丽东,孙政华,等.煎煮形式及配伍比例对党参黄芪复方免疫调节作用的影响.中国临床药理学杂志,2017,33(10):917-920,938
[18]卜红南.黄精多糖的提取及其免疫活性研究.实用医药杂志,2017,34(1):48-51,56
[19]赵俊云,杨向竹,牛欣,等.黄芪糖蛋白对T细胞增殖与活化的影响.中华中医药学刊,2015,33(1):49-50
[20]罗波,尧雪洲,廖敏,等.黄芪甲苷Ⅳ对卵清蛋白诱导的哮喘小鼠CD4+T细胞亚型Th1、Th2免疫活性的抑制作用.中华中医药杂志,2018,33(9):4071-4074
[21]李红玲,苏远,师少军,等.甲巯咪唑药品不良反应病例文献分析.药物流行病学杂志,2017,26(4):259-262
[22]郭昌贵.甲巯咪唑和丙硫氧嘧啶治疗甲亢安全性的回顾性分析.航空航天医学杂志,2017,28(3):340-341
[23]刘子毓.益气生血方治疗甲亢合并白细胞减少症的临床观察.长沙:湖南中医药大学,2015
[24]曾小红.黄芪注射液治疗甲巯咪唑引起甲亢患者白细胞减少症评价.辽宁中医药大学学报,2014,16(12):176-178
[25]王翔宇.黄芪现代药理及临床研究进展.科技风,2017,22(3):182
[26]张建军,胡春玲.中药党参研究的现代进展.甘肃高师学报,2017,22(3):39-43
[27]王慧,袁德培,曾楚华,等.黄精的药理作用及临床应用研究进展.湖北民族学院学报(医学版),2017,34(2):58-60,64
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