张兰教授治疗慢性淋巴细胞性甲状腺炎经验选萃
摘要
慢性淋巴细胞性甲状腺炎(Chronic Lymphocytic Thyroiditis, CLT),又称桥本氏病(Hashimoto’s Thyroiditis,HT),是各种甲状腺炎中比较常见的一种,约占甲状腺疾病的20%左右。本病多发于女性,以中青年为主。近年来,本病在临床的发病率逐年升高,且常可合并甲状腺癌或恶性淋巴瘤【1】,而现代医学认为本病与自身免疫有关,但对本病的免疫紊乱尚无有效的治疗方法,且停药后常易复发,其副作用超过了对机体的有利面,给治疗带来不便。张兰教授从医多年,对本病的治疗有其独特而丰富的经验,总结出一套中医治疗CLT的独特理论,从肝、脾、肾三脏,分早、中、晚三期进行辨证论治,取得了良好的临床疗效。
Chronic Lymphocytic Thyroiditis (CLT), named as Hashimoto’s Thyroiditis(HT), is very normal in the diseases of the thyroid gland, which takes about 20% of the diseases of the thyroid gland. It occurs primarily in the females, especially the mid-edged females. In recent years, the disease in clinical morbidity rate is gradually increased, which can be associated with thyroid cancer or lymphoma. Western medicine thinks it has a relationship with the autoimmunication. As a result, it also named autoimmune Thyroditis. However, the western medicine has no effect therapy to the irregulation of the disease. Professor Zhang has got particular and affluent experience to this kind of disease after dealing with medicine many years. She has concluded a distinctive theory of how to treat CLT with Traditional Chinese Medicine, which bases on the three zang-organs----the liver, the spleen and the kidney, and divided into three stages, and get satisfactory clinical effect.
Chronic Lymphocytic Thyroiditis (CLT), named as Hashimoto’s Thyroiditis(HT), is very normal in the diseases of the thyroid gland, which takes about 20% of the diseases of the thyroid gland. It occurs primarily in the females, especially the mid-edged females. In recent years, the disease in clinical morbidity rate is gradually increased, which can be associated with thyroid cancer or lymphoma. Western medicine thinks it has a relationship with the autoimmunication. As a result, it also named autoimmune Thyroditis. However, the western medicine has no effect therapy to the irregulation of the disease. Professor Zhang has got particular and affluent experience to this kind of disease after dealing with medicine many years. She has concluded a distinctive theory of how to treat CLT with Traditional Chinese Medicine, which bases on the three zang-organs----the liver, the spleen and the kidney, and divided into three stages, and get satisfactory clinical effect.
引文
[1]闫笑迎,杨柏柳,杨柳竹.甲状腺疾病中诊为桥本氏病的临床分析[J].河北医学,2003,9(9):827
[2]谢培凤.中西医结合治疗桥本甲状腺肿的临床研究[J].中国临床保健杂志,2005,8(3):198-200
[3]Leslie J et.al. Hashimoto’s thyruiditis:A disease of Autoimmunity [M]. Thyroid and its diseases 5th edition.1984,2:497
[4]Berger SA , Zonszein J, Villamena N. Infection diseases of the thyroid gland. Rev Infect Dis, 1983,5:102-122.
[5]Foley Tp Jr. The relationship between the autoimmue thyroid disease and iodine intake: a review. Endokrynol pol, 1992, 43, Suppl 1: 53-69
[6]Konno N et a1.J ain Endocrino1 Metab,1994:78(2):393-397
[7]Hall R, et al. Clin Exp Immunol, 1966,1:285
[8]卢秀鸾.曲竹秋教授治疗瘿病的临床经验.天津中医[J],2000, 17(2):3-4
[9]梅广源.梅教授治疗瘿病的临床经验.新中医[J],1990:(4) 30
[10]吴长富.瘿病诊治体会.黑龙江中医药,1992,(1);l9
[11]白耀.甲状腺病学—基础与临床[M].北京:科学技术文献出版社,2003:314-315
[12]姚军,王居易,杨会道.中医瘿病经络诊察的临床研究[J].中国针灸,2000,l0: 607-610
[13]胡军,李鼎.瘿病证治文献述评,浙江中医学院学报,1993,17(2):51
[14]高尚璞.汝丽娟教授治疗桥本甲状腺炎继发甲状腺功能减退症的经验[J].上海中医药杂志,2002,1:32-33
[15]潘文奎.中医诊治桥本甲状腺炎的特殊性[J].现代中医,1996,3(32):131-133
[16]谭忠华.自身免疫性甲状腺疾病诊疗中3种自身抗体的临床价值[J].南通医学院学报,2004,24 (2):152
[17]Hear M,Aust G,Ode-Halcim S,et a1.Different cytokine mRNA profile in Grave’s disease,Hashimoto’s thyroiditis and nonautoimmune thyroid disorders determined by quantitive reverse transcriptase polymerase chain reaction(RT—PCR)[J].Thyroid,1996,6;97—106.
[18]石秀林,倪安民.自身免疫性甲状腺疾病中Thl/Th2细胞平衡[J].国外医学:内分泌学分册,2003,23(增刊):47—48.
[19]Concepcion E,Davies T F.Mapping the major susceptibility loci for familial Graves’and Hashimoto’s diseases:evidence for genetic heterogeneity and gene interactions[J].J Clin En—docrinol Metab,1999,2(4):25-27
[20]Ban Y,Tomer Y.Susceptibility gene in thyroid autoimmunity[J].Clin Dev lmmunol,2005,12(1):47—58.
[21]lino Y,Hara H,Suda T,et a1.Co-existence of pemphigus vulgaris and Hashimoto’s thyroiditis[J].Eur J Dermatol,2005,15(1):40—2.
[22]王晓强,高权过.逍遥散的药理研究进展[J].中医药信息,2007,24(3):40-41.
[23]赵益业.肝郁症的免疫学探讨[J].山东中医药大学学报,1997,21(1):28-32
[24]邝安垫,沈自尹,王文健.虚证研究[M].上海:上海科学技术出版社,1991:71-105.
[25]许芝银.甲状腺疾病中医治疗[M].南京:江苏科学技术出版社. 2002:13.
[26]李永莲.补肾与活血.中医杂志[J],1996,37(10):585
[27]吴志勇,曹晖,邝耀麟.桥本甲状腺炎诊断和治疗方法的选择[ J ].外科理论与实践,1999,4 (4) :202
[28]崔鹏,高天舒,李贺.富碘中药治疗瘿病的研究进展[J].中华中医药学刊,2007,25(10):2090
[29]顾晓洁,钱士辉,李友宾等.夏枯草的化学成分及药理作用研究进展[J].中国野生植物资源,2007, 26(2):6
[30]陈江华.牡蛎提取物对免疫功能低下小鼠的正向免疫调节作用[J].第一军医大学学报,1997,18(2):149
[31]陈梅花,王慧春,朱艳媚等.贝母的药理研究[J].安徽农学通报,2007, 13 (1):103 - 105
[32]金在久.桔梗的化学成分及药理和临床研究进展[J].时珍国医国药,2007, 18(2):507
[33]陈海凤.浅谈中医药与免疫[J].光明中医,2003,18(4):6
[34]陈岩勤.浅议中医理论与现代免疫学[J].国医论坛,2005,11(6):50
[1]Leslie J.Hashimoto’s:A disease of autoimmunity The thyroid and its disease[M].5th edition.1984:497-546
[2]黄铮,唐汉钧.扶正清瘿法治疗桥本氏甲状腺炎52例[J].上海中医药杂志,2003,37(11):34.
[3]王桥专.加味柴胡疏肝汤治疗桥本氏病30例[J].实用中西医结合临床,2003,3( 6) :19
[4]楼映,阙华发,蒉纲.唐汉钧运用脾胃论观点治疗中医外科疾病举隅[J].上海中医药杂志,2004,38( 10) : 30
[5]陈爱华,邵桃.四七汤治疗桥本氏病35例疗效观察[J].新中医,2003,35(2):31-32
[6]潘文奎.中医诊治桥本甲状腺炎的特殊性[J].现代中医,1996,3: 131-133
[7]周长泉.桂枝茯苓丸治疗桥本病疗效观察[J].河北中医,2001,23(9): 691
[8]周桂荣,徐萍芝,崔鹏等.补中益气汤加味治疗桥本甲状腺炎60例[J].实用中医内科杂志,2007,21(2):66-67
[9]卞卫和,许芝银.扶正法在治疗甲状腺疾病中的应用[J].山西中医,1997,13(3):54
[10]赵树廷,李湘奇.消瘿合剂及甲状腺片治疗桥本甲状腺炎疗效观察[J].中国中西医结合外科杂志,2003,9(5):354-356
[11]任建民,吴茂红.夏枯草口服液辅助治疗桥本氏病甲状腺功能减低的临床观察[J].中日友好医院学报,2006,2O(5):315
[12]肖惠,寇艳涛.中西医结合治疗桥本氏甲状腺炎6O例临床分析[J].现代中医药,2005,25(4):20-21
[13]谢志君.中西医结合治疗桥本氏病[J].四川中医,2007,25(3):54-55
[14]王晓燕.隔药饼灸治疗慢性淋巴细胞性甲状腺炎[J].中国针灸,2003,23(1):6-8
[15]王永炎.今日中医外科[M].北京:人民卫生出版社,2000.102-104
[16]张罔珍,林哲章,陈爱美等.80例甲状腺结节的中西医结合治疗[J].福建中医药,1988,(4):9
[17]黄文智.外用消瘿膏治疗甲状腺肿临床观察及护理[J].湖北中医杂志,2007,29(8):46
[18]赵本贞.中国当代腺体病学[M].北京:中国中医药出版社,1993:84
[19]王立琴.外敷消瘿膏治疗甲状腺肿临床观察及实验初步研究[J].中医杂志,1993,34(3):153
[20]华川,许芝银.雷公藤治疗桥本氏甲状腺炎实验研究[J].实用中医药杂志,2003,19( 8): 397
[21]刘晓鸫,唐汉钧.扶正清瘿方治疗桥本氏甲状腺炎实验研究[J].中医药学刊,2004,22( 3):497
[22]王小宁,余江毅,顾志峰等.温肾方对自身免疫性甲状腺炎甲状腺组织TNF-α, IFN-γ表达的影响[J].江苏中医药,2005,1.(46):85
[23]余江毅,顾志峰.温肾方对自身免疫性甲状腺炎模型甲状腺组织IL-2表达的影响[J].中华实用中西医杂志,2005, 18 (16): 662-664
[24]潘春宇,张兰.软坚消瘿汤对实验性自身免疫性甲状腺炎的影响[J].光明中医,2007,22(7):77-78.
[25]吴定滨.35例桥本氏病针吸细胞学临床诊断分析[J].微创医学,2007年,2(4):339
[26]邓万凯,孙学华.甲状腺桥本病诊断与治疗体会[J].河南肿瘤学杂志,2001,l4(4):282-283
[27]闫笑迎,杨柏柳,杨柳竹.甲状腺疾病中诊为桥本氏病的临床分析[J].河北医学,2003,9(9):827
[2]谢培凤.中西医结合治疗桥本甲状腺肿的临床研究[J].中国临床保健杂志,2005,8(3):198-200
[3]Leslie J et.al. Hashimoto’s thyruiditis:A disease of Autoimmunity [M]. Thyroid and its diseases 5th edition.1984,2:497
[4]Berger SA , Zonszein J, Villamena N. Infection diseases of the thyroid gland. Rev Infect Dis, 1983,5:102-122.
[5]Foley Tp Jr. The relationship between the autoimmue thyroid disease and iodine intake: a review. Endokrynol pol, 1992, 43, Suppl 1: 53-69
[6]Konno N et a1.J ain Endocrino1 Metab,1994:78(2):393-397
[7]Hall R, et al. Clin Exp Immunol, 1966,1:285
[8]卢秀鸾.曲竹秋教授治疗瘿病的临床经验.天津中医[J],2000, 17(2):3-4
[9]梅广源.梅教授治疗瘿病的临床经验.新中医[J],1990:(4) 30
[10]吴长富.瘿病诊治体会.黑龙江中医药,1992,(1);l9
[11]白耀.甲状腺病学—基础与临床[M].北京:科学技术文献出版社,2003:314-315
[12]姚军,王居易,杨会道.中医瘿病经络诊察的临床研究[J].中国针灸,2000,l0: 607-610
[13]胡军,李鼎.瘿病证治文献述评,浙江中医学院学报,1993,17(2):51
[14]高尚璞.汝丽娟教授治疗桥本甲状腺炎继发甲状腺功能减退症的经验[J].上海中医药杂志,2002,1:32-33
[15]潘文奎.中医诊治桥本甲状腺炎的特殊性[J].现代中医,1996,3(32):131-133
[16]谭忠华.自身免疫性甲状腺疾病诊疗中3种自身抗体的临床价值[J].南通医学院学报,2004,24 (2):152
[17]Hear M,Aust G,Ode-Halcim S,et a1.Different cytokine mRNA profile in Grave’s disease,Hashimoto’s thyroiditis and nonautoimmune thyroid disorders determined by quantitive reverse transcriptase polymerase chain reaction(RT—PCR)[J].Thyroid,1996,6;97—106.
[18]石秀林,倪安民.自身免疫性甲状腺疾病中Thl/Th2细胞平衡[J].国外医学:内分泌学分册,2003,23(增刊):47—48.
[19]Concepcion E,Davies T F.Mapping the major susceptibility loci for familial Graves’and Hashimoto’s diseases:evidence for genetic heterogeneity and gene interactions[J].J Clin En—docrinol Metab,1999,2(4):25-27
[20]Ban Y,Tomer Y.Susceptibility gene in thyroid autoimmunity[J].Clin Dev lmmunol,2005,12(1):47—58.
[21]lino Y,Hara H,Suda T,et a1.Co-existence of pemphigus vulgaris and Hashimoto’s thyroiditis[J].Eur J Dermatol,2005,15(1):40—2.
[22]王晓强,高权过.逍遥散的药理研究进展[J].中医药信息,2007,24(3):40-41.
[23]赵益业.肝郁症的免疫学探讨[J].山东中医药大学学报,1997,21(1):28-32
[24]邝安垫,沈自尹,王文健.虚证研究[M].上海:上海科学技术出版社,1991:71-105.
[25]许芝银.甲状腺疾病中医治疗[M].南京:江苏科学技术出版社. 2002:13.
[26]李永莲.补肾与活血.中医杂志[J],1996,37(10):585
[27]吴志勇,曹晖,邝耀麟.桥本甲状腺炎诊断和治疗方法的选择[ J ].外科理论与实践,1999,4 (4) :202
[28]崔鹏,高天舒,李贺.富碘中药治疗瘿病的研究进展[J].中华中医药学刊,2007,25(10):2090
[29]顾晓洁,钱士辉,李友宾等.夏枯草的化学成分及药理作用研究进展[J].中国野生植物资源,2007, 26(2):6
[30]陈江华.牡蛎提取物对免疫功能低下小鼠的正向免疫调节作用[J].第一军医大学学报,1997,18(2):149
[31]陈梅花,王慧春,朱艳媚等.贝母的药理研究[J].安徽农学通报,2007, 13 (1):103 - 105
[32]金在久.桔梗的化学成分及药理和临床研究进展[J].时珍国医国药,2007, 18(2):507
[33]陈海凤.浅谈中医药与免疫[J].光明中医,2003,18(4):6
[34]陈岩勤.浅议中医理论与现代免疫学[J].国医论坛,2005,11(6):50
[1]Leslie J.Hashimoto’s:A disease of autoimmunity The thyroid and its disease[M].5th edition.1984:497-546
[2]黄铮,唐汉钧.扶正清瘿法治疗桥本氏甲状腺炎52例[J].上海中医药杂志,2003,37(11):34.
[3]王桥专.加味柴胡疏肝汤治疗桥本氏病30例[J].实用中西医结合临床,2003,3( 6) :19
[4]楼映,阙华发,蒉纲.唐汉钧运用脾胃论观点治疗中医外科疾病举隅[J].上海中医药杂志,2004,38( 10) : 30
[5]陈爱华,邵桃.四七汤治疗桥本氏病35例疗效观察[J].新中医,2003,35(2):31-32
[6]潘文奎.中医诊治桥本甲状腺炎的特殊性[J].现代中医,1996,3: 131-133
[7]周长泉.桂枝茯苓丸治疗桥本病疗效观察[J].河北中医,2001,23(9): 691
[8]周桂荣,徐萍芝,崔鹏等.补中益气汤加味治疗桥本甲状腺炎60例[J].实用中医内科杂志,2007,21(2):66-67
[9]卞卫和,许芝银.扶正法在治疗甲状腺疾病中的应用[J].山西中医,1997,13(3):54
[10]赵树廷,李湘奇.消瘿合剂及甲状腺片治疗桥本甲状腺炎疗效观察[J].中国中西医结合外科杂志,2003,9(5):354-356
[11]任建民,吴茂红.夏枯草口服液辅助治疗桥本氏病甲状腺功能减低的临床观察[J].中日友好医院学报,2006,2O(5):315
[12]肖惠,寇艳涛.中西医结合治疗桥本氏甲状腺炎6O例临床分析[J].现代中医药,2005,25(4):20-21
[13]谢志君.中西医结合治疗桥本氏病[J].四川中医,2007,25(3):54-55
[14]王晓燕.隔药饼灸治疗慢性淋巴细胞性甲状腺炎[J].中国针灸,2003,23(1):6-8
[15]王永炎.今日中医外科[M].北京:人民卫生出版社,2000.102-104
[16]张罔珍,林哲章,陈爱美等.80例甲状腺结节的中西医结合治疗[J].福建中医药,1988,(4):9
[17]黄文智.外用消瘿膏治疗甲状腺肿临床观察及护理[J].湖北中医杂志,2007,29(8):46
[18]赵本贞.中国当代腺体病学[M].北京:中国中医药出版社,1993:84
[19]王立琴.外敷消瘿膏治疗甲状腺肿临床观察及实验初步研究[J].中医杂志,1993,34(3):153
[20]华川,许芝银.雷公藤治疗桥本氏甲状腺炎实验研究[J].实用中医药杂志,2003,19( 8): 397
[21]刘晓鸫,唐汉钧.扶正清瘿方治疗桥本氏甲状腺炎实验研究[J].中医药学刊,2004,22( 3):497
[22]王小宁,余江毅,顾志峰等.温肾方对自身免疫性甲状腺炎甲状腺组织TNF-α, IFN-γ表达的影响[J].江苏中医药,2005,1.(46):85
[23]余江毅,顾志峰.温肾方对自身免疫性甲状腺炎模型甲状腺组织IL-2表达的影响[J].中华实用中西医杂志,2005, 18 (16): 662-664
[24]潘春宇,张兰.软坚消瘿汤对实验性自身免疫性甲状腺炎的影响[J].光明中医,2007,22(7):77-78.
[25]吴定滨.35例桥本氏病针吸细胞学临床诊断分析[J].微创医学,2007年,2(4):339
[26]邓万凯,孙学华.甲状腺桥本病诊断与治疗体会[J].河南肿瘤学杂志,2001,l4(4):282-283
[27]闫笑迎,杨柏柳,杨柳竹.甲状腺疾病中诊为桥本氏病的临床分析[J].河北医学,2003,9(9):827