基于“气有余便是火”理论治疗桥本甲状腺炎

Research Progress on Treatment of Hashimoto Thyroiditis Based on the Theory of “Qi Excess Is Fire”

摘要: 桥本甲状腺炎(Hashimoto’s Thyroiditis, HT)作为自身免疫性甲状腺疾病的典型代表，其病理特征表现为淋巴细胞浸润性甲状腺炎及进行性甲状腺功能损伤。本病以隐匿起病、渐进性发展为临床特点，早期多呈现甲状腺弥漫性肿大，随病程进展可逐渐演变为甲状腺功能减退状态。现代医学常规采用左旋甲状腺素替代疗法，虽能改善甲状腺功能指标，但在免疫调节及病程控制方面存在明显局限性。相较之下，中医学基于“整体观”和“辨证论治”原则，通过多靶点干预展现出独特治疗优势。值得注意的是，源自《丹溪心法》的“气有余便是火”理论近年来在HT的中医病机阐释与临床干预中取得突破性进展，相关基础与临床研究已成为该领域的前沿热点。

Abstract: Hashimoto’s Thyroiditis (HT), a typical representative of autoimmune thyroid diseases, is characterrized by lymphocytic infiltrating thyroiditis and progressive thyroid function injury. The clinical characteristics of this disease are insidious onset and progressive development. Diffuse enlargement of the thyroid gland is present in the early stage and may gradually evolve into hypothyroidism with the course of the disease. The conventional use of levothyroxine replacement therapy in modern medicine can improve thyroid function index, but there are obvious limitations in immune regulation and disease course control. In contrast, traditional Chinese medicine, based on the principles of “holistic view” and “syndrome differentiation and treatment”, shows its unique therapeutic advantages through multi-target intervention. It is worth noting that the theory of “qi excess is fire” derived from the “Danxi Heart Method” has made breakthrough progress in the pathogenesis interpretation and clinical intervention of HT in Chinese medicine in recent years, and related basic and clinical research has become a frontier hot spot in this field.