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中药复方从肝脾肾论治桥本甲状腺炎合并甲状腺功能减退症的研究进展
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Abstract:
桥本甲状腺炎合并甲状腺功能减退症是临床常见的内分泌疾病,近年来其发病率呈不断上升的趋势。西医治疗主要采取甲状腺激素替代疗法作为核心手段,虽有一定疗效,但长期使用需注意其潜在副作用和个体化剂量的调整。相比之下,中药复方通过从肝脾肾三脏入手,辨证施治,展现出在缓解症状、调节免疫、延缓病情进展及提高患者生活质量方面的显著优势。本文汇总并分析了相关文献,综述了从肝、脾、肾三脏出发治疗桥本甲减的理论认知与诊疗发展,旨在为该病的临床诊断和治疗提供新的思考路径。
Hashimoto’s thyroiditis with hypothyroidism is a common clinical endocrine disease, and its incidence has been increasing in recent years. Western medicine mainly adopts Thyroid hormone replacement therapy as its core method. Although it has some curative effect, it needs to pay attention to its potential side effects and individual dose adjustment for long-term use. In contrast, Chinese herbal medicine formula has shown significant advantages in relieving symptoms, regulating immunity, delaying disease progression and improving patients’ quality of life by treating liver, spleen and kidney according to syndrome differentiation. This article summarized and analyzed the related literature, and reviewed the development of the theory and treatment of hypothyroidism Hashimoto from the liver, spleen and kidney, in order to provide a new way of thinking for the clinical diagnosis and treatment of hypothyroidism.
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