【作者】 刘树民；

【导师】 李冀；

【作者基本信息】 黑龙江中医药大学 ， 方剂学， 2003， 博士

【摘要】 甲状腺功能亢进（简称“甲亢”）是指由多种原因引起的甲状腺激素过多，作用于全身的组织器官，造成机体的神经、循环、消化等系统兴奋性增高和代谢亢进为主要表现的疾病的总称，是一种与遗传、精神因素和自身免疫均有关系的疾病。中医认为本病的病因为情志所伤，饮食劳倦，水土失宜及体质因素，而以情志所致者为众。其病机多责之于肝的功能失调。其初起多实，主要病理因素为气滞、肝火、痰凝，而以气郁为先；久病多耗气伤阴或虚实夹杂，其病位在颈前，与肝、肾、心、脾胃关系密切。 甲亢病的中医治疗法则诸多，组方用药各有特色。本文在总结大量古今文献有关中医药治疗该病的经验和规律基础上，结合现代对该病病因病机及疾病演变特点的认识和研究，提出了以益气养阴、清肝散结为基本法则，并对其配伍用药原则进行系统研究。 通过药物拆方试验及系列研究结果表明，单用益气养阴方可降低基础代谢率，延长耐缺氧时间，具有良好的免疫调节作用，对T₄有降低作用；单用清肝散结方可抑制甲状腺肿大，延长耐缺氧时间，对甲亢患者T₃、T₄均有明显降低作用，但对免疫器官指数无影响。而两法相合对甲亢的各种指标均有显著治疗作用，尤其对血清T₄和吸¹³¹I率的改善作用尤为突出。证实益气养阴、清肝散结两法相合对甲亢有显著的治疗作用，其疗效优于两法单用，这与临床经验相符，说明在甲亢的治疗过程中，益气养阴药的应用有其独到作用。另外，实验结果提示益气养阴、清肝散结复方是作用于垂体前叶，通过抑制TSH分泌，而减少体内甲状腺素含量，从而起到对甲亢的治疗作用。更多还原

【Abstract】 Hyperthyroidism(Which is briefly called as "Jia Kang" in Chinese)is the general name of diseases with the excitement of nerve,circulatory,and digestion system of organism increasing and tachytrophism as the main appearances,which arise from the action of overmuch thyroid hormone induced by various reasons on the tissues and organs.lt is a kind of disease that is related to heredity,emotional tactors and self-immunity.In traditional Chinese medicine it is considered that the disease is caused by affect-mind damage,dietary fatigue,failure to adapt to a new environment and body factors,while the affect-mind damage is the main factor.The mechanism of disease is mostly attributed to disturbance of liver function.Firstly the repletion occupies the main factor,the main pathological factor is Qi obstruction,liver fire,phlegm congealing,while the Qi depression is the first;if disesse keeps too long ,Qi will be consumed,Yin will be damaged,or the vacuity and repletion are mixcd,the basic disease position is in front of neck, which is closely related to liver,kidney,heart,spleen and stomach.There are a lot of therapy methods in traditional Chinede medicine for hyperthyroidism,the prescription and use If medicines have different characteristics. On basis of summarizhing the experiencce and laws of treating the disease with traditional Chinese medicines in a large number of ancient and modern documents,in connection with the ?modern understanding and research on the disease causes,disease mechanism and the evolvement characters of and diseases,in the article the author puts forward to study the prescription laws of treating the disease with Qi-boosting,Yin-nourishing and liver-clearing congealing-dissipating as the basic princple.It is indicated by medicine prescription-dismantling tests and series of roconroh that if wo only use Qi-hoosting Yin-nourishiong,the hasal metabolic rate can be lowered,the anoxia-resistance time can be extcnded,there are sound immunity regulation actions,and the prescription can lower T4;if we only use liver-clearing congealing-dissipating prescription,the struma can be constrained,the anoxia-resistance time can be extended,this can apparently lower T3 and T4 of hyperthyroidism patients,but willnot influence the indices of immunity organs.If we combine the two kinds of methods,this will have marked therapy actions on various indices of hyperthyroidism,especially this will have apparent improvement actions on serum T4 and absorption 131I rate,This certifies that the combination of Qi-boosting Yin-nourishing method and liver-clearing congealing-dissipating method has marked therapy action on hyperthyroidism,the theraqy effect is better than either of therapy methods when they are used solely,this accords with the clinical experiences,This explains in the therapy process of hyperthyroidism,the application of Qi-boosting Yin-nourishing medicine has unique actions .In additional is prompted in the test results that the combination prescription medicine of Qi-boosting Yin-nourishing mthod and liver-clearing congealing-dissipating method acts on adnohypophysis,by constraining the secretion of TSH,the content of thyroid hormone will be reduced,so to realize the therapy on hyperthyroidism.更多还原