不同碘含量复方治疗瘿病的实验研究及临床经验总结
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摘要
目的测定常用软坚散结中药及复方的碘含量。方法从大量古今文献中筛选常用于治疗瘿病的软坚散结中药及复方，碱灰化法消化固体饮片，常规水煎中药及复方煎剂，采用中华人民共和国卫生部行业标准规定的方法：砷铈催化分光光度法。同一标本连续测定三次，取平均值。结果海藻饮片碘含量682.46 ug／kg，煎剂碘含量1951.75 ug／L；昆布饮片碘含量794.6ug／kg，煎剂碘含量1760.85 ug／L；黄药子饮片碘含量4.69 ug／kg，煎剂碘含量54.24 ug／L；海藻玉壶汤碘含量1951.75 ug／L；除去海藻、昆布、海带的海藻玉壶汤碘含量51.39 ug／L；消瘿瘤汤碘含量3829.50 ug／L。结论海藻、昆布为碘含量丰富的中药即富碘中药，海藻玉壶汤、消瘿瘤汤为富碘复方。
目的观察富碘复方(海藻玉壶汤)和非富碘复方(调甲平)对瘿病大鼠甲状腺功能和形态的影响及比较研究。方法复制瘿病大鼠模型，设正常对照组、模型对照组、单纯碘过量组、海藻玉壶汤组、调甲平组。观察各组大鼠甲状腺相对重量、血清TT_3、TT_4、TSH、r-T_3、甲状腺中的TT_3、TT_4、甲状腺滤泡上皮细胞高度、滤泡腔面积以及光学显微镜、透射电镜下甲状腺形态的变化。结果予海藻玉壶汤28天，甲状腺相对重量、血清TT_4、TSH、r-T_3、甲状腺中TT_3与正常对照组无显著差异，血清TT_4、r-T_3、甲状腺中TT_3高于模型对照组水平，甲状腺相对重量、血清TSH低于模型对照组水平，与模型对照组有显著差异。血清TT_3、甲状腺中TT_4、甲状腺滤泡腔面积高于正常水平。甲状腺滤泡上皮细胞高度低于正常水平，血清TT_3、甲状腺中TT_4、甲状腺滤泡上皮细胞高度、滤泡腔面积与正常对照组和模型对照组均有显著差异。处理因素28天，调甲平组甲状腺相对重量、TSH、甲状腺滤泡上皮细胞高度、滤泡腔面积与正常对照组无显著差异，与模型对照组有显著差异。血清TT_4、r-T_3、甲状腺中TT_3、TT_4低于正常对照组水平，高于模型对照组水平，与正常对照组和模型对照组均有显著差异。血清TT_3与正常对照组有显著差异，与模型对照组无显著差异。(P＜0.05)结论治疗瘿病的疗效，海藻玉壶汤优于单纯碘过量组，调甲平使甲状腺肿恢复完全，甲状腺功能(除TSH外)恢复不完全，缺乏治疗更长治疗时间的比较。高天舒教授认为瘿病包括阳瘿和阴瘿，阳瘿分为肝气郁结型，气滞血瘀型，肝火旺盛型，心肝火盛、肝肾阴虚型，肝阳上亢型：阴瘿分为肝气郁结型，肝郁脾虚型，脾气虚弱型，脾肾阳虚型，阳虚水泛型。临床上从肝脾肾论治，能明显降低甲状腺自身免疫抗体水平，对患者甲状腺激素水平起到双向调节作用，疗效显著。高天舒教授指出“夫治瘿病者，上工治肝，中工治脾，下工治肾”。
Objective: To mensurate the content of iodine in herbal medicine and compound prescription used in softening hard mass and disintegrating masses o Method: selected herbal medicine and compound prescription from masses of literature in all times, which were used in curing goiter, digestion fixed the herb of small pieces Alkali-ash method, decocted herbal medicine and compound prescription routinely, using People' s Republic of China medicaldepartment' professionstandard' stipulation: Arseniccerium catalysis spectrophotometric method. The same sample was mensurated three times, we chose the average. Result: the content of iodine in algae (herb of small pieces)was 682.46 ug/kg, while the result in decoction was 1951.75 ug/L; the content of iodine in kunbu (herb of small pieces)was 794.69 ug/kg, while the result in decoction was 1760.85 ug/L; the content of iodine in huangyaozi (herb of small pieces)was 4.69 ug/kg, while the result in decoction was 54.24 ug/L; the content of iodine in the decoction of haizaoyuhu was 1951.75 ug/ kg;but the result in haizaoyuhu decoction was 51.39 ug/h with the exception of algae、kubu、haidai; the content of iodine in the decoction of xiaoyingliu was 3829.50ug/kg. Conclusion: Algae and Kubu were full of iodine in herbal medicine, as well as the decoction of haizaoyuhu and the decoction of xiaoyingliu in compound prescription.Key words: softening hard mass and disintegrating masses; herbal medicine; compound prescription; the content of iodine
Objective: To study the effect of Tiaojiaping on thyroid function and morphology in goiter Wistar rats due to iodine deficiency.
Methods: Replicated Iodine-deficient Wistar rats and divided into 4 groups: normal group, model group, iodine excess group, Haizaoyuhutang group, Tiaojiaping group. Observed various outcome in each group, including the relative thyroid weight, serum TT3、TT4、TSH、rT3, thyroid TT3、TT4, the height of thyrocytes, the areas of thyroid follicular cavities and the thyroid morphological changes under optical microscope. Results: Giving the processing factor 28 days later, therelative thyroid weight、TSH、the height of thyrocytes and the areas of thyroid follicular cavities had no discrepancies in both Tiaojiaping group and the normal group, but there was obviously discrepancies in Tiaojiaping group and the model group. serum TT4、r-T3 and thyroid TT3、TT4 values inTiaojiaping group were obviously lower than normal group, obviously higher than model group, serum TT3 had obviously discrepancies in both Tiaojiaping group and the normalgroup, but no discrepancies existed in Tiaojiaping group and the model group(P＜0.05). Conclusion: Tiaojiaping results in the goiter in iodine deficiency Wistar rats completely recover, but the thyroid function(except TSH) does not completely recover. It lacks comparison with long therapy.
Objective: Professor Gao(Gaotianshu) think that goiter can be divide into two kinds Yang goiter and Yin goiter. The former one can be divide into Liver-Qi stagnation; Stagnation of Qi and blood; Liver-fire bloom; Excess-fire in the liver-heart; Deficiency-Ying in the liver-kidney; Hyperactivity of liver-Yangand the later one can be divided into Liver-Qi stagnation; Liver-Qi stagnation and spleen-Qi deficiency; Spleen-Qi deficiency; Deficiency-Yang in the Spleen-kidney: Flood due to deficiency-Yang. If Bianzheng Lunzhifrom liver, spleen and kidney is used in clinic, the level of self-immunity antibody in thyroid gland could be reduced obviously and there will be double-effect to the level of the patient' s goiter hormone, and the curative is observably. Professor Gaopoint out: To treat goiter, the best doctor treat Liver;the better one treat spleen and the common one treat kidney.
目的观察富碘复方(海藻玉壶汤)和非富碘复方(调甲平)对瘿病大鼠甲状腺功能和形态的影响及比较研究。方法复制瘿病大鼠模型，设正常对照组、模型对照组、单纯碘过量组、海藻玉壶汤组、调甲平组。观察各组大鼠甲状腺相对重量、血清TT_3、TT_4、TSH、r-T_3、甲状腺中的TT_3、TT_4、甲状腺滤泡上皮细胞高度、滤泡腔面积以及光学显微镜、透射电镜下甲状腺形态的变化。结果予海藻玉壶汤28天，甲状腺相对重量、血清TT_4、TSH、r-T_3、甲状腺中TT_3与正常对照组无显著差异，血清TT_4、r-T_3、甲状腺中TT_3高于模型对照组水平，甲状腺相对重量、血清TSH低于模型对照组水平，与模型对照组有显著差异。血清TT_3、甲状腺中TT_4、甲状腺滤泡腔面积高于正常水平。甲状腺滤泡上皮细胞高度低于正常水平，血清TT_3、甲状腺中TT_4、甲状腺滤泡上皮细胞高度、滤泡腔面积与正常对照组和模型对照组均有显著差异。处理因素28天，调甲平组甲状腺相对重量、TSH、甲状腺滤泡上皮细胞高度、滤泡腔面积与正常对照组无显著差异，与模型对照组有显著差异。血清TT_4、r-T_3、甲状腺中TT_3、TT_4低于正常对照组水平，高于模型对照组水平，与正常对照组和模型对照组均有显著差异。血清TT_3与正常对照组有显著差异，与模型对照组无显著差异。(P＜0.05)结论治疗瘿病的疗效，海藻玉壶汤优于单纯碘过量组，调甲平使甲状腺肿恢复完全，甲状腺功能(除TSH外)恢复不完全，缺乏治疗更长治疗时间的比较。高天舒教授认为瘿病包括阳瘿和阴瘿，阳瘿分为肝气郁结型，气滞血瘀型，肝火旺盛型，心肝火盛、肝肾阴虚型，肝阳上亢型：阴瘿分为肝气郁结型，肝郁脾虚型，脾气虚弱型，脾肾阳虚型，阳虚水泛型。临床上从肝脾肾论治，能明显降低甲状腺自身免疫抗体水平，对患者甲状腺激素水平起到双向调节作用，疗效显著。高天舒教授指出“夫治瘿病者，上工治肝，中工治脾，下工治肾”。
Objective: To mensurate the content of iodine in herbal medicine and compound prescription used in softening hard mass and disintegrating masses o Method: selected herbal medicine and compound prescription from masses of literature in all times, which were used in curing goiter, digestion fixed the herb of small pieces Alkali-ash method, decocted herbal medicine and compound prescription routinely, using People' s Republic of China medicaldepartment' professionstandard' stipulation: Arseniccerium catalysis spectrophotometric method. The same sample was mensurated three times, we chose the average. Result: the content of iodine in algae (herb of small pieces)was 682.46 ug/kg, while the result in decoction was 1951.75 ug/L; the content of iodine in kunbu (herb of small pieces)was 794.69 ug/kg, while the result in decoction was 1760.85 ug/L; the content of iodine in huangyaozi (herb of small pieces)was 4.69 ug/kg, while the result in decoction was 54.24 ug/L; the content of iodine in the decoction of haizaoyuhu was 1951.75 ug/ kg;but the result in haizaoyuhu decoction was 51.39 ug/h with the exception of algae、kubu、haidai; the content of iodine in the decoction of xiaoyingliu was 3829.50ug/kg. Conclusion: Algae and Kubu were full of iodine in herbal medicine, as well as the decoction of haizaoyuhu and the decoction of xiaoyingliu in compound prescription.Key words: softening hard mass and disintegrating masses; herbal medicine; compound prescription; the content of iodine
Objective: To study the effect of Tiaojiaping on thyroid function and morphology in goiter Wistar rats due to iodine deficiency.
Methods: Replicated Iodine-deficient Wistar rats and divided into 4 groups: normal group, model group, iodine excess group, Haizaoyuhutang group, Tiaojiaping group. Observed various outcome in each group, including the relative thyroid weight, serum TT3、TT4、TSH、rT3, thyroid TT3、TT4, the height of thyrocytes, the areas of thyroid follicular cavities and the thyroid morphological changes under optical microscope. Results: Giving the processing factor 28 days later, therelative thyroid weight、TSH、the height of thyrocytes and the areas of thyroid follicular cavities had no discrepancies in both Tiaojiaping group and the normal group, but there was obviously discrepancies in Tiaojiaping group and the model group. serum TT4、r-T3 and thyroid TT3、TT4 values inTiaojiaping group were obviously lower than normal group, obviously higher than model group, serum TT3 had obviously discrepancies in both Tiaojiaping group and the normalgroup, but no discrepancies existed in Tiaojiaping group and the model group(P＜0.05). Conclusion: Tiaojiaping results in the goiter in iodine deficiency Wistar rats completely recover, but the thyroid function(except TSH) does not completely recover. It lacks comparison with long therapy.
Objective: Professor Gao(Gaotianshu) think that goiter can be divide into two kinds Yang goiter and Yin goiter. The former one can be divide into Liver-Qi stagnation; Stagnation of Qi and blood; Liver-fire bloom; Excess-fire in the liver-heart; Deficiency-Ying in the liver-kidney; Hyperactivity of liver-Yangand the later one can be divided into Liver-Qi stagnation; Liver-Qi stagnation and spleen-Qi deficiency; Spleen-Qi deficiency; Deficiency-Yang in the Spleen-kidney: Flood due to deficiency-Yang. If Bianzheng Lunzhifrom liver, spleen and kidney is used in clinic, the level of self-immunity antibody in thyroid gland could be reduced obviously and there will be double-effect to the level of the patient' s goiter hormone, and the curative is observably. Professor Gaopoint out: To treat goiter, the best doctor treat Liver;the better one treat spleen and the common one treat kidney.
引文
1．滕卫平：再论碘摄入量变化对甲状腺疾病的影响(评论)。中华内分泌代谢杂志，2001，17(2)：69。
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1．滕卫平：再论碘摄入量变化对甲状腺疾病的影响(评论)。中华内分泌代谢杂志，2001，17(2)：69。
2．单忠艳，滕卫平，金迎，高天舒等碘致甲状腺功能减退症的流行病学对比研究。中华内分泌代谢杂志，2001，17(2)：71
3. Gao Tianshu Tengweiping Shan Zhongyan et al Effect of different iodine on schoolchildren' s thyroid diseases and intelligence in rural areas Chinese Medical Journal 2004;117(10):1518-1522
4．关海霞，滕卫平，高天舒等。不同碘摄入量地区甲状腺癌的流行病学研究，中华医学杂志2001，81(8)：50。
5．高天舒，胡风楠，滕卫平中轻度碘过量对非碘缺乏大鼠甲状腺功能和形态的影响 中华内科杂志，2003，Vol42，No．10，705-708
6．高天舒，滕卫平 中轻度碘过量对碘缺乏大鼠甲状腺功能和形态的影响 中华内分泌代谢杂志2004：20：353-356
7．高天舒，李静，滕卫平碘过量对Wistar大鼠甲状腺细胞凋亡及Fas/FasL表达的影响中华地方病学杂志2005(已修稿)
8．李仁廷黄独汤治疗甲状腺腺瘤116例，四川中医，2001；(10)：25
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12．方邦江、王丽清、周爽等．复方甲亢汤治疗甲状腺机能亢进症68例．新中医．2002．34(2)．51-52
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14．卞卫和、任晓梅．从痰论治甲状腺疾病的体会．湖南中医杂志．2001．17(5)．27-28
15．关勇健朱习文中医辨证治疗亚急性甲状腺炎湖北中医杂志2003，25(2)：32
16．邢一伟 辨证治疗甲状腺机能亢进 吉林中医药2001，(2)：13-14
17. 喻茂尧 甲状腺功能亢进症中西医结合治疗思路江西中医药2004，35(2)：34-35
1. Pederson DM, Aardac NP, Larssen TB. et al. The value of ul-trasonography in predicting autoimmune thyroidisease[J].Thyroid, 2000, 10 (3) :251-259.
2. Kawakami Y, Kuzuya N ,Watanabe T et al. Induction of ex-perimenta thyroiditis in mice by recombinant interferon gamma ad-ministration ,1990 ,122(1):41
3. Zipris D. Greiner DL, Malkam S, et al Cytokine gene expression in islets and thyroids of BB rats IFN-Y andI1-12 p40 mRNA in-crease with age both diabetic and insulin treated nondiabetic BB rats. J Inununol, 1996: 156:1315～1321
4．叶红奠综述自身免疫性甲状腺疾病的T细胞亚群异常．国外学者来访报告，1996；16：46～52
5. Romagnani S The Th1/Th2 paradigm, lmmunol Today, 1997; 18: 263～266
6．李迅庚，马宏岩．桥本氏病[J]．山东医药，2004，(36)：59-60．
7．姚榛祥．慢性淋巴细胞性甲状腺炎[J]．医师进修杂志，2005，(58)：4-5．
8．黄邱朝．IG类特异的抗甲状腺球蛋白，抗甲状腺微粒体抗体的定量分析与临床研究．上海免疫学杂志．1990，10(1)：27．
9．王聆，郑武飞．ELISA测定TMAB和TGAB的临床意义．中华内分泌代谢杂志．1989，5(2)：70．
10．胡国胜，陈汉平，侯永健，等．隔药灸治疗桥本氏甲状腺炎临床观察．中医杂志，1992，33(5)：30-32．
11．邝安神，沈自尹，王文健．虚证研究．上海：上海科学技术出版社，1991，71-105．
12．邝安堃. 原发性甲减的中西药治疗与疗效观察．中西医结合杂志，1988，8(2)：74．
13．刘德宜，刘光智，张超，等．小柴胡汤免疫调节作用的实验研究[J]．山东医药，2003，43(22)：26～27．
14．闻集普，姚昌绶，王伯祥．日本对小柴胡汤治疗慢性肝病的研究：疗效、机制与禁忌[J]．中西医结合肝病杂志，2004，14(6)：378～381．
15．聂有智、王春勇．小柴胡汤加味治疗桥本甲状腺炎50例．山东中医药大学学报，29(6)：451-452．
16．周长泉．桂枝茯苓丸治疗桥本病疗效观察．河北中医，2001，23(9)：691．
17．王刚勇．当归四逆汤临床应用体会．河北中医，2002，24(6)：433-434
18．王本祥．现代中药药理学．天津，天津科学技术出版社，1997，1294．
19．周文献，朱志军．加味金匮肾气汤治疗原发性甲状腺功能减退症．光明中医，2001，4：41．
20．陈文娟，钟妙文，杨劲松．真武汤加减治疗甲状腺功能减退症(脾肾阳虚型)30例疗效观察．新中医，2006，38(3)：41-42．
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9．Gao Tianshu Tengweiping Shan Zhongyan et al Effect of different iodine on schoolchildren's thyroid diseases and intelligence in rural areas Chinese Medical Journal 2004：117(10)：1518-1522
10．关海霞，滕卫平，高天舒等。不同碘摄入量地区甲状腺癌的流行病学研究，中华医学杂志2001，81(8)：50。
11．高天舒，胡凤楠，滕卫平中轻度碘过量对非碘缺乏大鼠甲状腺功能和形态的影响 中华内科杂志，2003，Vol42，No．10，705-708
12．高天舒，滕卫平 中轻度碘过量对碘缺乏大鼠甲状腺功能和形态的影响 中华内分泌代谢杂志2004；20：353-356
13．高天舒，李静，滕卫平碘过量对wistar大鼠甲状腺细胞凋亡及Fas/FasL表达的影响 中华地方病学杂志2005，24(3)：267-270。
14．喻茂尧甲状腺功能亢进症中西医结合治疗思路江西中医药2004，35(2)：34-35
15．李金春，刘浩智，李玉清 海藻玉壶汤加减治疗乳腺增生病104例 河北中医2003，25(4)：295。
16．穆惠荣，路继儒 海藻玉壶汤加减治疗前列腺增生症(附26例分析)医学理论与实践2003，1
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1．崔鹏，高天舒，戈娜，等．常用软坚散结中药及复方碘含量的测定．中华中医药学刊，2007，已修稿．
2. Norimich Konno, Hironi Makita, Kenji Yuri, Norio Ⅲuka and Kimio kavasaki Association between dietary iodine intake and prevalence of sublc linical hypothyroidism in the coastal regions of Japan. J Clin Endocrinol Metab 1994,78:393-397.
3. 于志恒，胡宣扬，朱惠民等 碘与甲状腺肿流行规律的调查研究 中国地方病学杂志1987，6：331-332。
4. Suzuki H. Endemic coast goiter in Hokkad. Acta Endocrinology, 1965(5):165.
5．滕卫平防治碘缺乏病与碘过量中华内分泌代谢杂志2002，18(3)：239。
6．高天舒，崔鹏，李静，等．海藻玉壶汤对碘缺乏致甲状腺肿大鼠甲状腺功能和形态的影响．中国中医基础医学杂志，2007，已录用．
7．邝安神，沈自尹，王文健．虚证研究．上海：上海科学技术出版社，1991，71-105．
8．胡国胜，陈汉平，侯永健，等．隔药灸治疗桥本氏甲状腺炎临床观察．中医杂志，1992，33(5)：30-32．
9．邝安堃.原发性甲减的中西药治疗与疗效观察．中西医结合杂志，1988，8(2)：74．
1．滕卫平：再论碘摄入量变化对甲状腺疾病的影响(评论)。中华内分泌代谢杂志，2001，17(2)：69。
2．单忠艳，滕卫平，金迎，高天舒等碘致甲状腺功能减退症的流行病学对比研究。中华内分泌代谢杂志，2001，17(2)：71
3. Gao Tianshu Tengweiping Shan Zhongyan et al Effect of different iodine on schoolchildren' s thyroid diseases and intelligence in rural areas Chinese Medical Journal 2004;117(10):1518-1522
4．关海霞，滕卫平，高天舒等。不同碘摄入量地区甲状腺癌的流行病学研究，中华医学杂志2001，81(8)：50。
5．高天舒，胡风楠，滕卫平中轻度碘过量对非碘缺乏大鼠甲状腺功能和形态的影响 中华内科杂志，2003，Vol42，No．10，705-708
6．高天舒，滕卫平 中轻度碘过量对碘缺乏大鼠甲状腺功能和形态的影响 中华内分泌代谢杂志2004：20：353-356
7．高天舒，李静，滕卫平碘过量对Wistar大鼠甲状腺细胞凋亡及Fas/FasL表达的影响中华地方病学杂志2005(已修稿)
8．李仁廷黄独汤治疗甲状腺腺瘤116例，四川中医，2001；(10)：25
9．蔡慎初应用海藻消瘿方治疗甲状腺腺瘤的疗效观察．中国中药杂志．1997：(2)：121
10．杨友文等，应用消瘿散治疗良性甲状腺肿临床研究．中医杂志．1998，39(9)：545
11．陈爱华邵桃四七汤治疗桥本氏病35例疗效观察．新中医2003．35(12)．31-32
12．方邦江、王丽清、周爽等．复方甲亢汤治疗甲状腺机能亢进症68例．新中医．2002．34(2)．51-52
13．曹国蓉甲状腺机能亢进症的辨证论治新中医1996：(9)：5-6
14．卞卫和、任晓梅．从痰论治甲状腺疾病的体会．湖南中医杂志．2001．17(5)．27-28
15．关勇健朱习文中医辨证治疗亚急性甲状腺炎湖北中医杂志2003，25(2)：32
16．邢一伟 辨证治疗甲状腺机能亢进 吉林中医药2001，(2)：13-14
17. 喻茂尧 甲状腺功能亢进症中西医结合治疗思路江西中医药2004，35(2)：34-35
1. Pederson DM, Aardac NP, Larssen TB. et al. The value of ul-trasonography in predicting autoimmune thyroidisease[J].Thyroid, 2000, 10 (3) :251-259.
2. Kawakami Y, Kuzuya N ,Watanabe T et al. Induction of ex-perimenta thyroiditis in mice by recombinant interferon gamma ad-ministration ,1990 ,122(1):41
3. Zipris D. Greiner DL, Malkam S, et al Cytokine gene expression in islets and thyroids of BB rats IFN-Y andI1-12 p40 mRNA in-crease with age both diabetic and insulin treated nondiabetic BB rats. J Inununol, 1996: 156:1315～1321
4．叶红奠综述自身免疫性甲状腺疾病的T细胞亚群异常．国外学者来访报告，1996；16：46～52
5. Romagnani S The Th1/Th2 paradigm, lmmunol Today, 1997; 18: 263～266
6．李迅庚，马宏岩．桥本氏病[J]．山东医药，2004，(36)：59-60．
7．姚榛祥．慢性淋巴细胞性甲状腺炎[J]．医师进修杂志，2005，(58)：4-5．
8．黄邱朝．IG类特异的抗甲状腺球蛋白，抗甲状腺微粒体抗体的定量分析与临床研究．上海免疫学杂志．1990，10(1)：27．
9．王聆，郑武飞．ELISA测定TMAB和TGAB的临床意义．中华内分泌代谢杂志．1989，5(2)：70．
10．胡国胜，陈汉平，侯永健，等．隔药灸治疗桥本氏甲状腺炎临床观察．中医杂志，1992，33(5)：30-32．
11．邝安神，沈自尹，王文健．虚证研究．上海：上海科学技术出版社，1991，71-105．
12．邝安堃. 原发性甲减的中西药治疗与疗效观察．中西医结合杂志，1988，8(2)：74．
13．刘德宜，刘光智，张超，等．小柴胡汤免疫调节作用的实验研究[J]．山东医药，2003，43(22)：26～27．
14．闻集普，姚昌绶，王伯祥．日本对小柴胡汤治疗慢性肝病的研究：疗效、机制与禁忌[J]．中西医结合肝病杂志，2004，14(6)：378～381．
15．聂有智、王春勇．小柴胡汤加味治疗桥本甲状腺炎50例．山东中医药大学学报，29(6)：451-452．
16．周长泉．桂枝茯苓丸治疗桥本病疗效观察．河北中医，2001，23(9)：691．
17．王刚勇．当归四逆汤临床应用体会．河北中医，2002，24(6)：433-434
18．王本祥．现代中药药理学．天津，天津科学技术出版社，1997，1294．
19．周文献，朱志军．加味金匮肾气汤治疗原发性甲状腺功能减退症．光明中医，2001，4：41．
20．陈文娟，钟妙文，杨劲松．真武汤加减治疗甲状腺功能减退症(脾肾阳虚型)30例疗效观察．新中医，2006，38(3)：41-42．