通讯作者: 白小林, bxl02185@126.com

DOI：10.12201/bmr.202506.00063

Syndrome Differentiation and Treatment of Thyroid Nodules Based on the Theory of Smooth Flow of Primordial True Qi in Five Zang-Organs

• 摘要：甲状腺结节在中医学中归属于“瘿病”范畴。随着公众健康意识的普遍提升和影像诊断技术的不断发展，甲状腺结节的临床检出率呈现逐年上升趋势。西医常采用定期复查、随访等方式，少部分采用手术、131I等方法，临床上虽取得一定的疗效，但容易出现肝功能损伤、甲减、骨质疏松等不良反应。中医在甲状腺结节的辨证论治方面具有显著特色和独特优势。白小林主任医师基于《金匮要略》“五脏元真通畅”理论，创新性地提出“枢机通畅”是该病治疗的关键所在。其治疗体系涵盖少阳枢机、脾胃枢机、少阴枢机等多个层面，确立以和解透达、枢转少阳为主，辅以疏肝行气、健脾化痰、活血散瘀、开阖枢机、通阳解郁等治疗原则。这一治疗策略旨在重建五脏元真之气机通畅，最终实现“阴阳自和，人即安和”的治疗目标。临床实践表明，该理论为甲状腺结节的中医治疗提供了新的诊疗思路和治疗路径。

  关键词： 甲状腺结节; “五脏元真通畅”; 枢机; 用药经验; 辨证论治

   

  Abstract: Thyroid nodules are classified under the category of goiter in traditional Chinese medicine.With the general improvement of public health awareness and the continuous development of imaging diagnostic techniques,the clinical detection rate of thyroid nodules has been increasing year by year.Western medicine often adopts regular reexamination and follow-up,and a small number of cases are treated with surgery or 131I,etc.Although certain therapeutic effects have been achieved in clinical practice,adverse reactions such as liver function damage, hypothyroidism,and osteoporosis are prone to occur.Traditional Chinese medicine has significant characteristics and unique advantages in the diagnosis and treatment of thyroid nodules based on syndrome differentiation.Dr. Bai Xiaolin,a chief physician,innovatively proposed that unobstructed pivot is the key to the treatment of this disease based on the theory of unobstructed qi of the five zang organs in Essential Prescriptions from the Golden Cabinet.His treatment system covers multiple levels such as the Shaoyang pivot,Spleen and Stomach pivot,and Shaoyin pivot,and establishes the treatment principles of harmonizing and penetrating, pivoting Shaoyang, supplemented by soothing the liver and regulating qi,strengthening the spleen and resolving phlegm,promoting blood circulation and removing stasis,opening and closing the pivot,and promoting yang and resolving depression.This treatment strategy aims to restore the smooth flow of qi of the five zang organs and ultimately achieve the therapeutic goal of harmony of yin and yang, and peace of the body. Clinical practice has shown that this theory provides new diagnostic and therapeutic ideas and treatment paths for the treatment of thyroid nodules with traditional Chinese medicine.

  Key words: Thyroid Nodules; Smooth flow of the vital essence in the five Zang-organs; pivotal mechanism; experience in medication administration; dialectical treatment based on syndrome differentiation

  提交时间：2025-06-24

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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  1	2025-06-03	10.12201/bmr.202506.00063V1	下载

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