郑怀刚 王凤英 邵迎新 汪虹 周云

    [摘要] 桥本甲状腺炎(HT)是一种自身免疫性疾病，可导致甲状腺组织结构和功能的改变，典型的症状是甲状腺肿或甲状腺结节。中医文献中没有HT的记载，中医学中将颈前甲状腺肿大为特征的疾病统称为瘿病，临床上HT主要是参照瘿病辨证论治。瘿病是由于情志内伤、饮食及水土失宜等因素引起的，以致气滞、痰凝、血瘀壅结颈前为基本病机。邵迎新教授认为HT不完全等同于瘿病，本病病程绵长，症状复杂，正气亏虚贯穿于其发生发展的全部过程，其病因为元气不足，即气虚，因正气亏虚，导致痰湿、瘀血等病理产物壅结颈前而发病，其病机关键为气虚、痰凝、血瘀。而且临床证实HT从气虚辨治，应用益气化瘀法治疗效果满意。本文希望通过病因病机的探讨，达成辨证共识，以简驭繁，提高疗效。

    [关键词] 桥本甲状腺炎；瘿病；气虚；辨证论治

    [中图分类号] R581 [文献标识码] A [文章编号] 1673-7210(2018)10(c)-0141-04

    [Abstract] Hashimoto′s thyoiditis (HT) is a clinical autoimmune thyroid disease， which leads to the pathology change of thyroid function and tissue structure， with typical clinical manisfestation of swollen thyroid or thyroid nodules. There is no record of HT in Chinese medicine literature. In traditional Chinese medicine， the disease characterized by the enlargement of the anterior cervical thyroid gland is called gall disease. Gall disease is caused by internal injury of mentality， abnormal diet， water and soil inappropriateness， with the basic pathogenesis of qi stagnation， phlegm， blood stasis accumulating anterior neck. Professor SHAO Yingxin thinks that HT is not exactly the same as gall disease. The disease has a long course ......