从太阴阳明升降气化理论探讨甲状腺功能亢进症病机与治疗

Exploration of Pathogenesis and Treatment of Hyperthyroidism from the Perspective of the Ascending-Descending Qi Transformation Theory of Taiyin and Yangming

摘要:

本文结合《素问·太阴阳明论》“阳道实，阴道虚”的阴阳升降气化理论，认为甲状腺作为“脾肺太阴之枢”，参与转化精微与宗气生成，其功能障碍导致精微不布、痰结颈前。基于此理论，提出甲状腺功能亢进症（甲亢） 的核心病机为“太阴不运，阳明积热”。从病机论治，确立“清阳明以存津，补太阴以复运”的治则，以白虎加人参汤为主方清泻胃热、益气生津，法张仲景“扶阳气存津液”。结合临床案例说明紧扣这一病机施治，不仅能显著改善甲亢主症，还能调节整体状态，缓解药物肝损伤及过敏反应，印证了以太阴阳明升降气化为指导论治甲亢的有效性与整体优势。

Abstract:

Abstract：Integrating the yin-yang ascending-descending qi transformation theory of "yang is substantial，yin is deficient" from the Su Wen·Tai Yin Yang Ming Lun （Plain Questions·Treatise on Taiyin and Yangming），this article posits that the thyroid， as the "pivot of Taiyin of the spleen and lung， " participates in transforming nutrients and generating ancestral qi. Its dysfunction leads to failure in distributing nutrients and phlegm accumulation in the anterior neck. Based on this theory， the core pathogenesis of hyperthyroidism is proposed to be "Taiyin dysfunction and Yangming accumulates heat . " Addressing the pathogenesis， the therapeutic principle is established as "clearing Yangming to preserve fluids， and supplementing Taiyin to restore function." The Baihu and Renshen Decoction is recommended to clear stomach heat， replenish qi， and generate fluids， following ZHANG Zhongjing's principle of "supporting yang qi and preserving body fluids." Clinical case studies demonstrate that adhering to this pathogenesis in treatment not only significantly alleviates hyperthyroidism symptoms but also regulates overall health status，mitigates drug-induced liver injury， and reduces allergic reactions. This validates the effectiveness and holistic advantages of treating hyperthyroidism based on the ascending-descending qi transformation theory of Taiyin and Yangming.