亚临床甲状腺功能减退症中西医结合诊疗方案探讨
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摘要
亚临床甲状腺功能减退(SCH)是指血清促甲状腺激素升高而甲状腺激素正常的病理状态,是血脂异常、心血管疾病及后代智力发育减低的独立危险因素。由于SCH无特殊的临床表现,又缺乏对SCH的系统研究,尚未形成详细的诊断和治疗标准,故容易漏诊和误诊。文章在中医"治未病"思想指导下,形成SCH的"辨病—辨体—辨证"诊疗模式,探讨建立科学有效的SCH中西医结合诊疗方案,延缓或阻止甲状腺亚临床减低状态向临床阶段发展。
Subclinical hypothyroidism( SCH) is the pathological state in which hormothyrin is increased and thyroid hormone is normal in serum. It is the independent risk factor of dyslipidemia,cardiovascular disease and insufficient intelligence development in the later generation. There is no specific clinical manifestation and lack of the systematic study of SCH. It is limited in the specification on the diagnosis and treatment. Hence,the miss-diagnosis and misdiagnosis easily result in. In the paper,under the guidance of the preventive treatment of disease,the diagnostic pattern of"the disease differentiation,the body differentiation and the syndrome differentiation"of SCH was formed,the scientific and effective regimen of integrative Chinese and western medicine was explored for SCH so as to delay or block SCH to be developed to the clinical phase.
Subclinical hypothyroidism( SCH) is the pathological state in which hormothyrin is increased and thyroid hormone is normal in serum. It is the independent risk factor of dyslipidemia,cardiovascular disease and insufficient intelligence development in the later generation. There is no specific clinical manifestation and lack of the systematic study of SCH. It is limited in the specification on the diagnosis and treatment. Hence,the miss-diagnosis and misdiagnosis easily result in. In the paper,under the guidance of the preventive treatment of disease,the diagnostic pattern of"the disease differentiation,the body differentiation and the syndrome differentiation"of SCH was formed,the scientific and effective regimen of integrative Chinese and western medicine was explored for SCH so as to delay or block SCH to be developed to the clinical phase.
引文
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[11]王耀立.亚临床甲减中医体质特征及半夏厚朴汤加减对痰气交阻证的临床干预初步研究[D].北京:中国中医科学院,2016.
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[14]韩煦.魏军平教授甲减诊疗经验总结及半夏厚朴汤加味治疗亚甲减临床疗效评价[D].北京:北京中医药大学,2017.
[15]Lazarus J,Brown RS,Daumerie C,et al. 2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children[J]. Eur Thyroid J,2014,3(2):76-94.
[2]Shan Z,Chen L,Lian X,et al. Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for16 years in China:A cross-sectional study in 10 cities[J]. Thyroid,2016,26(8):1125-1130.
[3]Teng W,Shan Z,Teng X,et al. Effect of iodine intake on thyroid diseases in China[J]. N Engl J Med,2006,354(26):2783-2793.
[4]王耀立,魏军平.亚临床甲状腺功能减退症中医研究进展[J].中国临床保健杂志,2016,19(3):334-336.
[5]Somwaru LL,Rariy CM,Arnold AM,et al. The natural history of subclinical hypothyroidism in the elderly:the cardiovascular health study[J]. J Clin Endocrinol Metab,2012,97(6):1962-1969.
[6]Liu H,Shan Z,Li C,et al. Maternal subclinical hypothyroidism,thyroid autoimmunity,and the risk of miscarriage:a prospective cohort study[J]. Thyroid,2014,24(11):1642-1649.
[7]Ergür AT,Taner Y,Ata E,et al. Neurocognitive functions in children and adolescents with subclinical hypothyroidism[J]. J Clin Res Pediatr Endocrinol,2012,4(1):21-24.
[8]中华医学会内分泌学分会.成人甲状腺功能减退症诊治指南[J].中华内分泌代谢杂志,2017,33(2):167-180.
[9]王智民,高天舒.基于“治未病”理论探讨亚临床甲状腺功能减退症防治[J].辽宁中医药大学学报,2015,17(9):98-100.
[10]王秋虹,魏军平.基于中医体质学说论亚临床甲状腺功能减退症的防治[J].中国中医药信息杂志,2012,19(10):95-96.
[11]王耀立.亚临床甲减中医体质特征及半夏厚朴汤加减对痰气交阻证的临床干预初步研究[D].北京:中国中医科学院,2016.
[12]王秋虹,魏军平.甲状腺功能减退症中医证治研究述评[J].世界中西医结合杂志,2012,7(11):1005-1007.
[13]王秋虹.亚临床甲状腺功能减退症中医体质特征及与证型相关性研究[D].北京:中国中医科学院,2013.
[14]韩煦.魏军平教授甲减诊疗经验总结及半夏厚朴汤加味治疗亚甲减临床疗效评价[D].北京:北京中医药大学,2017.
[15]Lazarus J,Brown RS,Daumerie C,et al. 2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children[J]. Eur Thyroid J,2014,3(2):76-94.