甲状腺结节的发病机制及中医治疗进展
Pathogenesis of Thyroid Nodules and Progress in TCM Treatment
DOI: 10.12677/acm.2024.1482333, PDF,   
作者: 沈会鑫*:黑龙江中医药大学研究生院,黑龙江 哈尔滨;樊 蓉#, 刘春雨:黑龙江中医药大学附属第二医院哈南分院内分泌科,黑龙江 哈尔滨
关键词: 甲状腺结节发病机制中医治疗Thyroid Nodules Pathogenesis Traditional Chinese Medicine Treatment
摘要: 甲状腺结节作为常见的内分泌疾病,它的发生和发展机制是复杂的,纵横交错,与胰岛素抵抗、饮食中碘摄入异常、内分泌失调、炎症因子、细胞凋亡异常、细胞因子失衡有关,还与遗传、物理刺激、性别、吸烟等因素有关。但对于其致病机制的研究仍不充分。目前西医对于甲状腺结节的治疗手段丰富,但其治疗效果并不令人满意。甲状腺结节的出现对患者的生活质量影响非常严重,因此对甲状腺结节的发病机制进行深入研究,寻找有效的治疗手段尤为必要。
Abstract: As a common endocrine disease, thyroid nodules have a complex and criss-crossing mechanism of occurrence and development, which is related to insulin resistance, abnormal iodine intake in diet, endocrine disorders, inflammatory factors, abnormal apoptosis, cytokine imbalance, and also related to genetics, physical stimulation, gender, smoking and other factors. However, the mechanism of pathogenesis is still insufficient. At present, Western medicine has a variety of treatment methods for thyroid nodules, but the treatment effect is not satisfactory. The appearance of thyroid nodules has a very serious impact on the quality of life of patients, so it is particularly necessary to conduct in-depth research on the pathogenesis of thyroid nodules and find effective treatment methods.
文章引用:沈会鑫, 樊蓉, 刘春雨. 甲状腺结节的发病机制及中医治疗进展[J]. 临床医学进展, 2024, 14(8): 1150-1155. https://doi.org/10.12677/acm.2024.1482333

参考文献

[1] Holzer, K. and Bartsch, D.K. (2020) Struma Nodosa. Der Chirurg, 91, 712-719. [Google Scholar] [CrossRef] [PubMed]
[2] Yildirim Simsir, I., Cetinkalp, S. and Kabalak, T. (2019) Review of Factors Contributing to Nodular Goiter and Thyroid Carcinoma. Medical Principles and Practice, 29, 1-5. [Google Scholar] [CrossRef] [PubMed]
[3] Bilgici, B., Ecemis, G.C., Tuncel, O.K., Bayrak, I.K., Kan, E.K. and Atmaca, A. (2013) VEGF and GM-CSF Levels in Nodular Thyroid Diseases. Endocrine, 45, 61-66. [Google Scholar] [CrossRef] [PubMed]
[4] Ayturk, S., Gursoy, A., Kut, A., Anil, C., Nar, A. and Tutuncu, N.B. (2009) Metabolic Syndrome and Its Components Are Associated with Increased Thyroid Volume and Nodule Prevalence in a Mild-To-Moderate Iodine-Deficient Area. European Journal of Endocrinology, 161, 599-605. [Google Scholar] [CrossRef] [PubMed]
[5] Chen, W., Zheng, R., Baade, P.D., Zhang, S., Zeng, H., Bray, F., et al. (2016) Cancer Statistics in China, 2015. CA: A Cancer Journal for Clinicians, 66, 115-132. [Google Scholar] [CrossRef] [PubMed]
[6] 李小勤, 崔凡, 钱增堃, 等. 2型糖尿病患者体内胰岛素样生长因子1与甲状腺结节的相关性研究[J]. 医学研究杂志, 2021, 50(2): 53-56.
[7] Răcătăianu, N., Leach, N., Bondor, C.I., Mârza, S., Moga, D., Valea, A., et al. (2017) Thyroid Disorders in Obese Patients. Does Insulin Resistance Make a Difference? Archives of Endocrinology and Metabolism, 61, 575-583. [Google Scholar] [CrossRef] [PubMed]
[8] Shan, Z., Chen, L., Lian, X., Liu, C., Shi, B., Shi, L., et al. (2016) Iodine Status and Prevalence of Thyroid Disorders after Introduction of Mandatory Universal Salt Iodization for 16 Years in China: A Cross-Sectional Study in 10 Cities. Thyroid, 26, 1125-1130. [Google Scholar] [CrossRef] [PubMed]
[9] 刘犇, 王芳, 刘凤磊, 等. Gal-3、CK19、HBME-1、cyclinD1、p53在甲状腺乳头状癌中的诊断价值[J]. 兰州大学学报(医学版), 2022, 48(4): 50-55.
[10] Deng, Y., Zhang, J., Zou, G., Li, S., Gong, Z., Yue, G., et al. (2022) Peripheral Blood Inflammatory Markers Can Predict Benign and Malignant Thyroid Nodules. International Journal of Endocrinology, 2022, Article ID: 2319660. [Google Scholar] [CrossRef] [PubMed]
[11] Destek, S. (2021) Clinical Significance of Erythrocyte Sedimentation Rate, Leukocyte, Fibrinogen, C Reactive Protein and Pentraxin-3 Values in Thyroid Nodules. The Medical Bulletin of Sisli Hospital, 56, 270-275. [Google Scholar] [CrossRef] [PubMed]
[12] 徐利本, 吴朝阳, 王远东. PI3K/Akt信号传导通路在肿瘤发生发展及治疗中的作用[J]. 现代肿瘤医学, 2021, 29(1): 177-180.
[13] 唐萃, 杨磊, 王旎, 等. G蛋白偶联雌激素受体1、表皮生长因子受体和趋化因子受体1在甲状腺乳头状癌中的表达及意义[J]. 第三军医大学学报, 2014, 36(12): 1317-1321.
[14] 董金茹, 阎玉芹. 甲状腺生长及功能的调控因子[J]. 天津医科大学学报, 2007(2): 307-310.
[15] 于晓会, 单忠艳. 甲状腺结节的病因与流行病学趋势[J]. 中国普外基础与临床杂志, 2011, 18(8): 800-802.
[16] 管丽佳, 陈洁. 陈洁主任中西医结合治疗甲状腺结节经验[J]. 陕西中医, 2015, 36(4): 479-480.
[17] 裴瑞霞, 汪德芬, 白小林, 等. 高上林治疗甲状腺结节经验[J]. 陕西中医, 2012, 33(10): 1378-1379.
[18] 贾春利, 吕建东, 支忠继, 等. 疏肝散结方治疗甲状腺结节作用机制探讨[J]. 河北中医药学报, 2021, 36(3): 46-49.
[19] 王冰梅, 马建, 杜丽坤, 等. 贝牡莪消丸治疗气郁痰阻型良性甲状腺结节的临床疗效观察[J]. 哈尔滨医科大学学报, 2018, 52(4): 347-350.
[20] 杨文学. 富碘复方海藻玉壶汤对碘缺乏甲状腺细胞凋亡及凋亡调控基因表达的影响[D]: [硕士学位论文]. 沈阳: 辽宁中医药大学, 2008.
[21] 张微, 张明海, 胡君. 小金丸联合夏枯草胶囊治疗桥本甲状腺炎伴结节的效果及对炎症因子的影响[J]. 中国当代医药, 2022, 29(7): 78-81.
[22] 刘春雪, 等. 腹针配合围刺治疗良性甲状腺结节[J]. 长春中医药大学学报, 2022, 38(1): 84-87.
[23] 魏珂, 柳杨, 黄石玺. 黄石玺应用毫火针联合电针治疗良性甲状腺结节[J]. 中国民间疗法, 2020, 28(12): 36-38.
[24] 厉馨, 陈敬博, 杨百京. 针刺配合药物治疗甲状腺结节的疗效观察[J]. 上海针灸杂志志, 2020, 39(11): 1366-1370.
[25] 王脉桃, 张亚萍, 宋卫红, 等. 夏棱消瘿汤联合黄药子膏药贴敷治疗甲状腺结节痰结血瘀证45例[J]. 环球中医药, 2020, 13(8): 1346-1349.
[26] 赖倚文. 瘿肿消软膏剂开发及穴位贴敷治疗结节性甲状腺肿的临床研究[D]: [博士学位论文]. 沈阳: 辽宁中医药大学, 2019.
[27] 胡树清, 裘雪冬. 温灸结合口服内消瘰疬丸治疗甲状腺结节的临床疗效[J]. 海峡药学, 2015, 27(2): 163-164.
[28] 潘文. 10.6μm激光灸对肾阳虚大鼠下丘脑-垂体-甲状腺轴的调节作用[D]: [硕士学位论文]. 上海: 上海中医药大学, 2020.
[29] 胡国胜, 陈汉平, 侯永建, 等. 隔药灸治疗桥本氏甲状腺炎临床观察[J]. 中医杂志, 1992(5): 30-32.
[30] 孙晶, 孟宪伟, 马晓菲. 刮痧结合四海舒郁丸治疗单纯甲状腺肿肝气郁结证的临床观察[J]. 中国地方病防治杂志, 2014, 29(4): 278-279.
[31] 马静, 魏溪芳, 王赛男. 穴位埋线治疗单纯性甲状腺肿大疗效观察[J]. 中国民间疗法, 2017, 25(6): 15-16.
[32] 魏玉婷, 曹朝霞, 李小娟, 等. 穴位埋线疗法的分子生物学机制研究进展[J]. 中华中医药杂志, 2019, 34(8): 3633-3636.
[33] 呼怡媚, 方学敏, 黄煊, 等. 中药配合耳穴贴压磁珠治疗甲状腺结节的疗效观察[J]. 中国医学工程, 2012, 20(11): 33-35.
[34] 陈翰翰, 时光喜. 散结片联合耳穴压豆治疗良性甲状腺结节的临床观察[J]. 中华中医药杂志, 2020, 35(3): 1586-1589.