从心肝脾辨证角度治疗甲亢合并失眠经验总结

Summary of Experience in Treating Hyperthyroidism Complicated with Insomnia from the Perspective of Differentiation of Heart, Liver and Spleen

摘要: 甲亢全称为甲状腺功能亢进症，是一种由甲状腺分泌过量的甲状腺激素所导致的疾病，临床上表现为心慌、甲状腺肿大、突眼、多汗、烦躁等，属于内分泌系统疾病。甲状腺功能亢进患者通常会出现多种并发症，其中睡眠不足是最普遍也是最棘手的一种，对患者的生活品质有很大的影响。现代医药在临床上已有较好的疗效，但是睡眠障碍需要采用镇静剂来帮助患者睡眠，导致患者长时间容易形成依赖和抗药性。近年来随着中医的发展，临床采用中西医结合的方法，可以有效地补充西医的缺点，在防治和减轻甲亢合并失眠等并发症方面起到了一定的效果。笔者在长期从事内分泌类疾病的诊治过程中，认为从中医角度，瘿病合并不寐与脾有很强的相关性，若以益气补血、健脾养心为治则，疗效确切。基于此，本研究从心肝脾辨证角度治疗甲状腺功能亢进伴睡眠障碍的体会进行了阐述，笔者选取乌鲁木齐市中医医院内分泌科2020年1月~2023年1月收治的60例甲亢合并失眠患者进行辨证分析，从中医心肝脾辨证角度治疗甲亢合并失眠经验，旨在为今后的临床工作和科研工作提供借鉴，现总结如下。

Abstract: Hyperthyroidism, the full name of hyperthyroidism, is a disease caused by the secretion of excessive thyroid hormone by the thyroid gland, clinically manifested as palpitation, goiter, bulging eyes, hyperhidrosis, irritability, etc., which belongs to the endocrine system disease. Patients with hyperthyroidism often experience a variety of complications, of which lack of sleep is the most common and intractable one, which has a great impact on the quality of life of patients. Modern medicine has a good clinical effect, but sleep disorders need to use sedatives to help patients sleep, resulting in long-term dependence and drug resistance. In recent years, with the development of traditional Chinese medicine, the clinical use of integrated traditional Chinese and Western medicine can effectively supplement the shortcomings of Western medicine, and play a certain effect in preventing and reducing complications such as hyperthyroidism combined with insomnia. The author has been engaged in the process of diagnosis and treatment of endocrine diseases for a long time. From the perspective of traditional Chinese medicine, gall disease combined with insomnia and spleen has a strong correlation, if the qi tonifies blood, spleen and heart as the treatment principle, the effect is exact. Based on this, this study expounds the experience of treating hyperthyroidism combined with sleep disorders from the perspective of differentiation of heart, liver and spleen. The author selects 60 cases of hyperthyroidism combined with insomnia treated in the Endocrinology Department of Urumqi Hospital of Traditional Chinese Medicine from January 2020 to January 2023 for syndrome differentiation analysis, and analyzes the experience of treating hyperthyroidism combined with insomnia from the perspective of differentiation of heart, liver and spleen of traditional Chinese medicine. In order to provide reference for future clinical work and scientific research work, it is summarized as follows.