[1]崔伟更,张 兰.慢性淋巴细胞性甲状腺炎亚临床期病机探析[J].陕西中医,2021,(5):632-634.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.022]
　CUI Weigeng,ZHANG Lan.Analysis of subclinical pathogenesis of chronic lymphocytic thyroiditis[J].,2021,(5):632-634.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.022]
点击复制

慢性淋巴细胞性甲状腺炎亚临床期病机探析
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2021年5期
页码:
632-634
栏目:
学术探讨
出版日期:
2021-05-05

文章信息/Info

Title:
Analysis of subclinical pathogenesis of chronic lymphocytic thyroiditis
作者:
崔伟更1; 张 兰2
(1.辽宁中医药大学,辽宁 沈阳 110032; 2.辽宁中医药大学附属医院,辽宁 沈阳 110032)
Author(s):
CUI Weigeng; ZHANG Lan
(Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)
关键词:
慢性淋巴细胞性甲状腺炎;  亚临床期;  肝脾;  理论探析;  病因病机;  发病机制
Keywords:
Chronic lymphocytic thyroiditis;  Subclinical stage;  Liver depression and spleen deficiency syndrome;  Theoretical analysis;  Etiology and pathogenesis;  Pathogenesis
分类号:
R 581
DOI:
DOI:10.3969/j.issn.1000-7369.2020.05.022
文献标志码:
A
摘要:
慢性淋巴细胞性甲状腺炎(CLT)是临床常见的自身免疫性甲状腺疾病,以无疼痛、弥漫性甲状腺肿大,伴有甲状腺自身抗体滴度升高为特征。慢性淋巴细胞性甲状腺炎分为三期,CLT亚临床期治疗是逆转疾病进程关键阶段,该期患者呈现相对可逆性,如早期进行干预,能够逆转其向甲状腺功能异常期进展,中医对CLT亚临床期的辨证治疗具有独特优势。本文从CLT亚临床期的中医病机特点,结合CLT亚临床期的临床表现及病理特点,阐述CLT亚临床期发病的中医病机核心是肝郁脾虚,以及其与西医免疫功能紊乱、甲状腺细胞凋亡的相关性为切入点探析CLT亚临床期发病机制,为慢性淋巴细胞性甲状腺炎亚临床期的治疗提供坚实理论依据。
Abstract:
Chronic lymphocytic thyroiditis(CLT)is a common autoimmune thyroid disease in clinic.It is characterized by painless,diffuse goiter and high titer of thyroid autoantibody.The stages of chronic lymphocytic thyroiditis are subclinical stage,hyperthyroidism stage and hypothyroidism stage.The treatment of CLT in subclinical stage is the key stage to reverse the disease process.The patients in this stage are relatively reversible.If early intervention,it is possible to reverse the progression to abnormal thyroid function.TCM has unique advantages in the treatment of CLT in subclinical stage.Based on the characteristics of TCM pathogenesis in subclinical stage of CLT,combined with the clinical manifestations and pathological characteristics of CLT,this paper expounds that the core of TCM pathogenesis of CLT in subclinical stage is liver depression and spleen deficiency,and its correlation with immune function disorder and thyroid cell apoptosis in western medicine as the breakthrough point to explore the pathogenesis of CLT subclinical stage,so as to improve the treatment of chronic lymphocytic thyroiditis in subclinical stage.

参考文献/References:

[1] Caturegli P,Remigis DA,Chuang K,et al.Hashimoto's thyroiditis:Celebrating the centennial through the lens of the johns hopkins hospital surgical pathology records[J].Thyroid,2013,23(2):142-150.
[2] 张进安,王一理,雏文田,等.T细胞受体Vβ基因在自身免疫性甲状腺病病变组织中的表达及意义[J].中华病理学杂志,2001,30(4):268-272.
[3] 徐蓉娟,葛芳芳.“病症结合”辨治桥本甲状腺炎[J].上海中医药大学学报,2016,30(1):1-3.
[4] 陈志敏,邵迎新.桥本甲状腺炎的中西医治疗研究进展[J].中国医药导报,2011,8(8):9-10.
[5] Hak AE,Pols HA,Visser TJ,et al.Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in dlderly women:The rotterdam study[J].Annals of Internal Medicine,2000,132(4):270-278.
[6] 宋林科,周 琦,徐鑫利.超声造影联合超声弹性成像对桥本甲状腺炎患者甲状腺结节良恶性的诊断价值[J].陕西医学杂志,2020,49(11):1472-1475.
[7] 李 珊.消瘿方治疗气阴两虚型桥本甲状腺炎及对甲状腺自身抗体水平的影响[J].陕西中医,2017,38(11):1581-1582.
[8] 王美子,杨宇峰,石 岩.中医瘿病的古文献研究[J].江苏中医药,2018,50(12):74-77.
[9] Marique L,Van RV,Gérard AC,et al.The expression of dual oxidase,thyroid peroxidase,and caveolin-1 differs according to the type of immune response(Th1/Th2)involved in thyroid autoimmune disorders[J].Journal of Clinical Endocrinology & Metabolism,2014,99(5):1722-1732.
[10] Killebrew JR,Perdue N,Kwan A,et al.A self-reactive TCR drives the development of Foxp3+ regulatory T cells that prevent autoimmune disease[J].Journal of Immunology,2011,187(2):861.
[11] Liu H,Zheng T,Mao Y,et al.Gammadelta Tau cells enhance B cells for antibody production in Hashimoto's thyroiditis,and retinoic acid induces apoptosis of the gammadelta Tau cell [J].Endocrine,2016,51(1):113-122.
[12] Weetman AP.Autoimmune thyroid disease:Propagation and progression [J].Eur J Endocrinol,2003,148(1):1-9.
[13] Rodien P,Madec AM,Morel Y,et al.Assessment of antibody dependent cell cytotoxicity in autoimmune thyroid disease using porcine thyroid cells [J].Autoimmunity,1992,13(3):177-185.
[14] Tedelind S,Ericson LE,Karlsson JO,et al.Interferon-gamma down-regulates claudin-1 and impairs the epithelial barrier function in primary cultured human thyrocytes [J].Eur J Endocrinol,2003,149(3):215-221.
[15] Phenekos C,Vryonidou A,Gritzapis AD,et al.Th1 and Th2 serum cytokine profiles characterize patients with Hashimoto's thyroiditis(Th1)and Graves' disease(Th2)[J].Neuroimmunomodulation,2004,11(4):209-213.
[16] Rebuffat SA,Kammoun KM,Charfeddine Ⅰ,et al.IL-1beta and TSH disturb thyroid epithelium integrity in autoimmune thyroid diseases [J].Immunobiology,2013,218(3):285-291.
[17] Esfahanian F,Ghelich R,Rashidian H,et al.Increased levels of serum interleukin-17 in patients with Hashimoto's thyroiditis [J].Indian J Endocrinol Metab,2017,21(4):551-554.
[18] Hammond LJ,Lowdell MW,Cerrano PG,et al.Analysis of apoptosis in relation to tissue destruction associated with Hashimoto's autoimmune thyroiditis[J].Journal of Pathology,2015,182(2):138-144.
[19] 柴 智,樊慧杰,周文静,等.逍遥散对雷公藤致急性肝损伤大鼠肝脏组织Bcl-2、Bax蛋白表达及Caspase-3活性的影响[J].中医杂志,2018,59(15):1328-1331.
[20] 王家红,张 兰.软坚消瘿颗粒对AIT大鼠细胞因子Th1/Th2及凋亡蛋白Fas/FasL、Bcl-2/Bax的影响[J].辽宁医学院学报,2015,36(2):9-12.

备注/Memo

备注/Memo:
基金项目:沈阳市科技计划项目(19-112-4-074)
更新日期/Last Update: 2021-05-10