1.中国中医科学院中国医史文献研究所,北京市东城区东直门内南小街16号,100700
2.中国中医科学院研究生院
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收稿:2025-01-24,
修回:2025-03-11,
纸质出版:2025-07-02
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宋昱佼,祝敏,蒋卓男等.从“肝主疏泄”探析甲状腺结节、乳腺结节、子宫肌瘤的共性病机及治疗[J].中医杂志,2025,66(13):1409-1412.
SONG Yujiao,ZHU Min,JIANG Zhuonan,et al.Treatment of Thyroid Nodules,Breast Nodules,and Uterine Fibroids Based on the Theory of "Liver Governing the Free Flow of Qi"[J].Journal of Traditional Chinese Medicine,2025,66(13):1409-1412.
宋昱佼,祝敏,蒋卓男等.从“肝主疏泄”探析甲状腺结节、乳腺结节、子宫肌瘤的共性病机及治疗[J].中医杂志,2025,66(13):1409-1412. DOI: 10.13288/j.11-2166/r.2025.13.018.
SONG Yujiao,ZHU Min,JIANG Zhuonan,et al.Treatment of Thyroid Nodules,Breast Nodules,and Uterine Fibroids Based on the Theory of "Liver Governing the Free Flow of Qi"[J].Journal of Traditional Chinese Medicine,2025,66(13):1409-1412. DOI: 10.13288/j.11-2166/r.2025.13.018.
以“肝主疏泄”为指导,认为肝疏泄失常导致气滞、痰凝、瘀阻是甲状腺结节、乳腺结节、子宫肌瘤三病的共性核心病机;气滞、痰凝、瘀阻既是重要的病理产物,又可阻碍肝之疏泄,二者相互影响,互为因果。临证主张以疏肝理气解郁为治法,方用通气散为基础方,灵活加减。针对肝郁气滞证,方以通气散加减以疏肝理气;气滞痰凝证,方以通气散合参苓白术散加减以疏木调土,化痰散结;气滞血瘀证,方以通气散合桃红四物汤加减以行气活血,通络消积。同时根据甲状腺结节、乳腺结节、子宫肌瘤病位不同的特点,随症增减药物,以期标本兼治。
Guided by the theory of "liver governing the free flow of
qi
", it is believed that liver fail to govern the free flow of
qi
may lead to
qi
stagnation, phlegm coagulation, and stasis, which is the core pathogenesis of thyroid nodules, breast nodules and uterine fibroids;
qi
stagnation, phlegm coagulation, and stasis are not only the important pathological products, but also the obstruction to the liver's function, and the two affect each other as the cause of each other. In clinic, it is advocated that using the treatment method of soothing the liver, rectifying
qi
, and resolving constraint, with prescription of
Tongqi Powder
(通气散) as the basic formula, and modified according to symptoms. For liver depression and
qi
stagnation syndrome, the formula chooses modified
Tongqi Powder
to soothe the liver and rectify
qi
; for
qi
stagnation and phlegm coagulation syndrome, the formula chooses modified
Tongqi Powder
plus
Shenling Baizhu Powder
(参苓白术散) to soothe the wood and regulate the earth, and resolve phlegm and dissipate masses
; for
qi
stagnation and blood stasis syndrome, the formula applies modified
Tongqi Powder
plus
Taohong Sizu Decoction
(桃红四物汤) to move
qi
and invigorate blood circulation, unblock the collaterals and dispel accumulation. At the same time, according to the characteristics of thyroid nodules, breast nodules, and uterine fibroids and their different disease locations, medicinals were added or subtracted according to the symptoms, so as to treat both the symptoms and the root cause of the disease simultaneously.
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方妍 . 中医“肝主疏泄”理论源流与发展的研究 [D]. 长春 : 长春中医药大学 , 2019 .
张晋冀 , 李绍林 , 邢玉瑞 . 基于象思维的“肝主疏泄”理论探赜 [J]. 辽宁中医药大学学报 , 2019 , 21 ( 9 ): 87 - 90 .
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