Integrated TCM and Western Medical Management of Hashimoto’s Thyroiditis

桥本氏甲状腺炎的中西医结合治疗策略

Integrated TCM and Western Medical Management of Hashimoto’s Thyroiditis

🔬 疾病概述 | Overview

桥本氏甲状腺炎（Hashimoto's thyroiditis）是最常见的自身免疫性甲状腺疾病，主要特征为自身免疫系统对甲状腺组织的持续性破坏，最终可能导致甲状腺功能减退（Hypothyroidism）。
Hashimoto’s thyroiditis is the most prevalent autoimmune thyroid disorder, characterized by chronic lymphocytic infiltration and progressive thyroid dysfunction, often leading to hypothyroidism.

🩺 一、西医治疗原则 | 1. Western Medical Principles

• 甲状腺激素替代疗法（Levothyroxine）
  对于甲状腺功能低下的患者，首选标准治疗是左旋甲状腺素（Levothyroxine）替代疗法，维持正常甲状腺激素水平。剂量必须依据患者体重、年龄、TSH水平、共病情况个体化制定，严禁自行服药。
  Levothyroxine replacement remains the gold standard in managing hypothyroid states. Dosage must be personalized based on TSH levels, age, body weight, and comorbidities. Self-medication is strongly discouraged.

• 免疫相关营养支持
  一些研究表明，维生素D、硒（Selenium）对抗氧化应激、调节免疫功能有一定辅助作用，但不适用于所有人群，应由医生评估后决定是否补充。
  Nutritional support such as selenium and vitamin D has shown promise in modulating autoimmune response. However, supplementation should be guided by clinical evaluation and testing.

• 定期检测甲状腺功能指标
  必须定期监测TSH、FT4、TPOAb等指标，动态评估病情发展。
  Thyroid function tests, including TSH, FT4, and TPO antibodies, should be monitored regularly to adjust treatment plans accordingly.

🌿 二、中医辨证治疗思路 | 2. Traditional Chinese Medicine (TCM) Individualized Approach

中医认为本病属“瘿病”范畴，其根源常在脾肾亏虚、肝郁气滞、痰湿阻滞，治疗需“辨证论治”，而非千人一方。每位患者的体质、症状、脉象等均需中医专家辨识后，定制草药处方和调理方案。
TCM classifies Hashimoto’s under the category of “Ying” (goiter) disorders. The root causes often involve spleen-kidney deficiency, liver qi stagnation, and phlegm-damp obstruction. Treatment must follow a precise pattern differentiation (bian zheng lun zhi), emphasizing individual customization.

• 常见证型及治疗思路 (Common TCM Patterns & Therapeutic Concepts)：

  • 脾肾阳虚型（寒象明显）：温阳扶正，用附子理中汤、右归丸类；

  • 痰湿壅盛型（舌苔厚腻、体型肥胖）：化痰散结，用海藻玉壶汤加减；

  • 肝郁气滞型（情绪波动大）：疏肝解郁，用柴胡疏肝散、逍遥散类；

  • 气阴两虚型（疲乏心悸）：益气养阴，用生脉散、炙甘草汤类。

  - Kidney-spleen yang deficiency: warming and tonifying formulas (e.g. Fuzi Lizhong Tang).
  - Phlegm-damp accumulation: resolving phlegm and softening nodules (e.g. Haizao Yuhu Tang).
  - Liver qi stagnation: soothing liver and regulating qi (e.g. Chaihu Shugan San).
  - Qi and yin deficiency: tonifying and nourishing (e.g. Sheng Mai San).

⚠️ 重要提醒：中草药方必须由具有资质的中医师根据舌脉象及整体体征综合开立，切不可从网上自行购买“通用甲状腺中药”盲目服用，以免病情恶化或损伤其他脏腑功能。
⚠️ Caution: Chinese herbal prescriptions must be customized by licensed practitioners. Self-medicating with generic online thyroid remedies can be dangerous and may worsen the condition.

🎯 三、综合诊疗建议 | 3. Integrative Management Recommendations

✅ 强调个体差异：每位患者的免疫状态、甲状腺激素水平、体质差异都不相同，治疗方案必须个性化设计。
✅ 中西医联合管理：西医控制激素水平，中医调整体功能，降低抗体水平、延缓疾病进展。
✅ 调整生活方式：保持情绪平稳、控制压力、适度运动、避免碘过量摄入及高敏食物。

✅ Emphasize individualization: No two patients are the same. Treatment must be customized.
✅ Combine strengths of both systems: Western medicine stabilizes hormones, while TCM supports systemic regulation and immune modulation.
✅ Lifestyle: Stress reduction, balanced nutrition, and avoidance of iodine excess or inflammatory foods are essential.

📍如需中医远程健康咨询、个性化草药代买服务，欢迎联系：
📧info@tcmhospital.com
For personalized health consultation or teleconsultation, contact us at:
📧 info@tcmhospital.com