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从脾分期论治甲状腺功能减退合并高脂血症OA

Stage-based treatment of hypothyroidism with hyperlipidemia from the spleen perspective

中文摘要英文摘要

甲状腺功能减退症(简称:甲减)与高脂血症是常见的两种内分泌代谢紊乱疾病,二者发病存在关联.甲减伴高脂血症在临床多见,常出现体质量增加、疲乏无力、水肿、消化不良等症状,严重者可伴随心血管系统、神经系统、生殖系统等多系统并发症.中医学以辨证论治为原则,整体审察,标本兼治.相对于单纯的西医治疗,中西医结合治疗能更好地改善患者生活质量,同时防止疾病进一步发展.中医学认为此类疾病属于"瘿病""脂浊"范畴,根据疾病发展与辨证可分为早期(肝郁脾虚)、中期(脾阳不足)、晚期(脾肾阳虚).从脏腑辨证角度看,瘿病与脂浊的疾病发展皆与脾关系密切,脾作为生痰之源与运化之枢,既是病理产物痰湿的生成核心,也是疾病传变的关键环节.脾虚生湿,湿聚成痰,痰湿困脾,阻滞中焦气机,形成相互加重的恶性循环.治疗应以辨证论治为基础,以健脾为核心环节,治病求本,防止疾病进展.现结合临床案例,介绍从脾论治甲减合并高脂血症的经验,以期为临床提供参考.

Hypothyroidism and hyperlipidemia are common endocrine and metabolic disorders with demonstrated pathological connections.Their clinical co-occurrence often manifests as weight gain,fatigue,edema,and digestive distur-bances,potentially progressing to multi-system complications.Traditional Chinese medicine(TCM)adopts a holistic ap-proach through syndrome differentiation and stage-based classification:early stage(liver depression and spleen defi-ciency),middle stage(spleen yang deficiency),and late stage(spleen-kidney yang deficiency).From the perspective of visceral syndrome differentiation,the progression of both goiter and lipid turbidity is closely related to the spleen.As the source of phlegm production and the pivot of transportation and transformation,the spleen is not only the core for generating pathological products such as phlegm-dampness but also a key link in the transmission and transformation of diseases.Spleen deficiency induces dampness accumulation,progressing to phlegm-dampness obstruction that further aggravates spleen dysfunction,creating a self-perpetuating cycle.Treatment should prioritize spleen reinforcement based on syndrome differentiation to address the root cause and prevent disease progression.This article presents clinical cases demonstrating spleen-focused stage differentiation therapy for hypothyroidism with hyperlipidemia,providing references for clinical practice.

刘振鑫;李锦涛;杨凛然;邓奕辉

湖南中医药大学第一中医临床学院,湖南 长沙 410072湖南中医药大学第一中医临床学院,湖南 长沙 410072湖南中医药大学第一中医临床学院,湖南 长沙 410072湖南中医药大学,湖南 长沙 410208

医药卫生

甲状腺功能减退高脂血症瘿病脂浊脾虚分期论治

hypothyroidismhyperlipidemiagoiterlipid turbidityspleen deficiencystage-based treatment

《山西中医药大学学报》 2026 (1)

43-50,8

湖南省自然科学基金创新研究群体项目(2024JJ1007)湖南省科技创新团队项目(2020RC4050)

10.19763/j.cnki.2096-7403.2026.01.19

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