桥本甲状腺炎 （Hashimoto’ s thyroiditis，HT） 是一种常见的内分泌疾病，可归属中医“瘿病”范畴。刘敏教授认为，桥 本甲状腺炎的发病与心胆关系密切，其病机在于胆郁不降、枢机不利，心气不足、营卫失和；治疗桥本甲状腺炎时常选用 柴胡桂枝汤加减 （药物组成主要为柴胡、桂枝、黄芩、法半夏、红参、炙甘草、大枣、白芍、龙骨、牡蛎、生姜） 。柴胡桂 枝汤可疏胆解郁，运转少阳枢机，调营卫，益心神，契合桥本甲状腺炎胆郁不降、心气不足之病机。临证治疗桥本甲状腺 炎时需根据患者兼证进行药味的加减，注意药物剂量的调整。除药物治疗外，还应重视对患者生活方式、饮食习惯的调整 及情绪的疏导，以取得显效。

Hashimoto’s thyroiditis （HT） is a common endocrine disease， which can be classified into the category of goiter disease in traditional Chinese medicine. Professor LIU Min believes that the pathogenesis of HT is closely related to the heart and gallbladder，and its pathogenesis is due to the gallbladder constraint failing to descend and the disturbance of pivot，together with insufficient heart-qi and the disharmony between the nutritive qi and the defensive qi. For the treatment of HT，the modified Chaihu Guizhi Decoction is often used，which is mainly composed of Bupleuri Radix，Cinnamomi Ramulus，Scutellariae Radix，Pinelliae Rhizoma Praeparatum， Ginseng Radix et Rhizoma Rubra，Glycyrrhizae Radix et Rhizoma Praeparata cum Melle，Jujubae Fructus， Paeoniae Radix Alba，Os Draconis，Ostreae Concha，and Zingiberis Rhizoma Recens. Chaihu Guizhi Decoction has the actions of soothing gallbladder and relieving depression， restoring the function of shaoyang pivot， regulating nutritive qi and the defensive qi，and benefiting heart spirit，which exactly accords with the HT’ s pathogenesis of gallbladder constraint failing to descend and insufficient heart-qi. In the clinical treatment of HT， the modification of the drugs should be performed according to the concurrent syndromes of the patients，and the dosage of the drugs should also be adjusted. In addition to drug treatment，the attention should also be addressed to the adjustment of patients' lifestyle and dietary habits and to the emotional counseling，thus to achieve significant effect.

R259.814

国家自然科学基金资助项目 （编号：81373767）