张兰从"郁火"论治亚急性甲状腺炎OACSTPCD

Subacute thyroiditis is often caused by pathological products such as bad mood,stagnation of Liver Qi and obstruction of Phlegm and Qi,which leads to the stagnation of Heat and obstruction of the neck.In addition,it is invaded by external factors such as the Six Yin evil factors,and the Qi movement is not smooth,leading to the transformation and the stagnation of Heat."Stagnation of Fire"runs through the entire process of subacute thyroiditis.Qi stagnation,Phlegm coagulation and blood stasis are the key factors that cause stagnation of Fire,and in clinical practice,a combination of multiple external and internal injury factors can lead to Qi and blood stasis combined with Phlegm,stagnation of Fire in the front of the neck,resulting in this disease.The treatment should be guided by the theory of"stagnation of Fire".On the one hand,the stagnation of Fire should be spread upwards and outwards;on the other hand,it is necessary to follow the upward and downward trend of the transmission of the depressed Fire,and to clear and relieve depressed fire by descending downwards and inwardly.It is also possible to identify the source of the Fire based on the cause of the depressed fire.If the fire comes from outside,it should be dispersed from the surface;Fire that originates from within should be cleared from inside.In the treatment of subacute thyroiditis,on the basis of clearing Heat and detoxifying,regulating Qi and eliminating Phlegm,promoting blood circulation and unblocking stagnation,medicines with pungent and fragrant characters can be given.Yinqiao Powder combined with Xiao Chaihu Decoction can be used with modifications to improve the state of stagnation of fire and internal stasis in patients,thereby allevia-ting a series of clinical manifestations such as fever and neck pain caused by the stagnation of Qi and blood and the combination of Phlegm,depression,and Fire in subacute thyroiditis.