Philosophy Chinese Medicine | Jianpi and Liver, Liver, Liver, Liver, and Loise, Determination of the Sequence

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"Dynamic-Fan Fan Guan Fan's Eight Dharma" is the theory of traditional Chinese medicine proposed by Professor Fan Guanjie. For many years of research and practice of the team, the book "Philosophy Traditional Chinese Medicine-" Moving-Preface to Fan Fan's Eight Laws "and the clinical thinking of Chinese medicine use philosophy to interpret Chinese medicine and verify philosophy through traditional Chinese medicine. Through the push of this column, it is hoped that Chinese medicine practitioners will develop their thinking and improve the clinical level.

Medical Guidance: Director of the Department of Endocrinology of the Department of Endocrinology of Guangdong Province, Fan Guanjie, an academic leader

The thyroid nodule refers to the unilateral or multiple thyroid tissue group blocks that grow abnormally, which are mostly found by the physical examination or accident. It can occur in people of all ages, but more common in middle -aged women. Most patients may have no obvious symptoms, and some of the front of the neck can be seen. There are benign and malignant in the pathological nature. The malignant nodules are mainly thyroid cancer, and the incidence rate accounts for about 5%to 15%of the entire nodule. For asymptomatic nodules of thyroid gland, special treatment is usually not required, and it can be regularly reviewed every six years or a year. If you have local discomfort or compression symptoms, you can timely evaluate and determine whether conservative intervention or surgical treatment is required.

Traditional Chinese medicine has a rich understanding of thyroid nodules, and has formed a relatively systematic experience of discrimination. At present, it mainly belongs to the category of "瘿 disease", emphasizing that the cause of the disease is inaccurate, diet imbalance, emotional disorders, and congenital endowment, etc. Among them, internal injuries are important causes of the disease. Long -term worry or depression and anger, the most likely to cause liver loss and abolition, and the gas machine is chaotic; if the liver prosperous and the spleen is lost, the spleen main water valley fluid is transported and faulty. Gathering, or because of cold condensation, or sputum due to fire, or even hindering blood veins for a long time, then phlegm and stasis are metastasized, condensed in front of the neck, and sent as "瘿 disease". Professor Fan Guanjie's "dynamic-orderly" dialectical theory emphasizes the laws and changes in dynamic grasping diseases, closely linked the core of the pathogenesis, and the cure was applied in an orderly manner.

【Examination Cases】

Li, female, 59 years old.

First diagnosis: December 22, 2020.

Prosecutor: It was found that the thyroid nodule was more than 6 years. In the past, the system was not diagnosed and treated, and now I am conscious of being tired and fatigue.

Find: The tongue is pale and dark, the moss is white, the bottom of the tongue is dark, and the veins are slightly thin. The thyroid Ⅱ degree is large, and multiple nodular changes can be touched on the left side. In the past, menstrual rules, occasional dysmenorrhea, blood clots, have been menopausal. There is no other special medical history on the head and neck. There is no abnormality in thyroid function and related antibodies. On December 15, 2020, the color Doppler ultrasound prompts the thyroid gland more nodules. Among them, the larger on the left 19 mm × 12 mm × 10 mm (low echo, morphological rules, clear borders, a little blood flow signal, tirads grades 3) Essence

Traditional Chinese medicine diagnosis: tumor (liver and spleen disorders, phlegm stasis interoperability).

Western medicine diagnosis: multiple thyroid nodules (benign change).

Governing the law: Yiqi and spleen, relieve liver and qi, and dispel phlegm.

Prescription: astragalus 15 g, Codonopsis 10 g, atractylodes 10 g, Poria 15 g, fried malt 15 g, frying barley 30 g, North Chaihu 10 g, bergamot 10 g, Yami mushroom 10 g, Zhejiang Fritillaria 10 g , Oyster 20 g (fry first), Guizhi 10 g, Chuanxiong 10 g, Angelica 5 g, Salva 15 g, Zhimu 10 g, licorice 10 g. 14 doses, decoction, 1 dose in 2 days, once/day.

In addition, the Danjie Sanjie cream is applied to the anterior thyroid area of ​​the neck.

Instructed to keep your mood comfortable, regularly work, and a light diet.

Two diagnosis: January 22, 2021.

After the 14 doses above the service, the conscious fatigue improved significantly compared with the front. Find: The tongue is slightly dull, the fur is slightly greasy, the bottom of the tongue is dark, and the veins are slightly thin. The patient's phlegm dampness is reduced before, and the image of blood stasis blocked is still relatively prominent. To the front side of the Poria, the fried coix seed is reduced to 15 g, plus the three edges 10 g, and the power of the Curdia 10 G to reduce the blood stasis. Take another 14 doses, the decoction method is the same as before. Continue to apply the thyroid region of Danjie Sanjie Ointment.

Third diagnosis: February 23, 2021.

After taking the upper service, there is no fatigue and uncomfortable discomfort. Qi deficiency improves, go to astragalus in front, take 14 doses, and decorate in front.

Fourth Diagnosis: March 22, 2021.

The patient has no special discomfort, Namian can, the second stool, the tongue is red, thin white, the bottom of the tongue, the stasis of the tongue is significantly reduced, and the pulse is smooth. Review the thyroid color Doppler ultrasound, indicating that the left nodule is significantly reduced (10 mm × 6 mm × 7 mm), and the remaining is basically the same as before.

The three -diagnosis prescription is given to the triggea and Curdia to avoid over -injury. Take another 10 doses.

Since then, the interruption is continued, and the prescription will increase or decrease slightly. After 3 months of follow -up, the state is good consciously. It is recommended to review the thyroid color Doppler ultrasound and reply to the sound of no abnormal nodules.

【note】

One of the cores of Professor Fan Guanjie's "Dynamics-Fan Fan Guan Fan's Eight Dharma" is "Heng Dynamic Guan", emphasizing that the human body's disease is a dynamic change process of righteous and evil struggles. Therefore The different characteristics of the disease and the stage of the stage must be adjusted flexibly, that is, "movement". The thyroid nodule is a relatively slow disease. The initial stage is mostly based on liver stagnation, and the first treatment is the main treatment of the liver and qi; In the later period, phlegm and heat stasis still exist, or gradually become the main contradiction; However, no matter what the disease changes, adhere to the principle of "referring to the core symptoms of the core of the core of the core symptoms, close the core lesion, and the medication for the treatment of the medicine" that Professor Fan Guanjie emphasizes it. The patients in this case are women in middle -aged and elderly people. The thyroid nodule history has a history of more than 6 years. The neck is swollen, accompanied by consciousness and fatigue, poor, and stool. In the past, menstruation occasionally had dysmenorrhea, blood clots, combined with tongue veins, and syndrome distinguished as spleen phlegm and blood stasis mutual mutual mutual alternatives. There are liver stagnation, treating the qi and strengthening the spleen, relieving liver and qi. Fangzhong Astragalus, Codonopsis, Atractylodes, Poria, Stir -fried Coix and Qi Qi and Qi to remove dampness; fried malt appetors; Bupleurum, bergamot to sparse liver and qi; Yami mushrooms, Zhejiang Fritillaria, oyster phlegm disperse; Guizhi, Chuanxiong, Chuanxiong, Chuanxiong Angelica and Danshen promoted blood circulation and removing blood stasis instead of injury; knowing the mother's diarrhea and fire; licorice tunes and the medicines, and given the Danjian Sanniexi to apply the thyroid region to strengthen the power of activating blood circulation and stasis. Adjust the medication according to the patient's consultation. Due to the long history of the patient, there is already a manifestation of exhaustion and fatigue at the time of consultation. , And when the Chinese disease is still, it is precisely to eliminate evil and not hurt, and assist the Tanbian Sanjie cream local treatment, emotional guidance and diet regulation, etc. The improvement, the nodules gradually narrowed, the evil went to the right place, and the effect was significant.

In summary, Professor Fan Guanjie emphasized that the key to the disease in the process of developing the disease was not static, but the "concept of constant dynamic" in dynamic changes. Therefore, in the process of developing the development of thyroid nodules, the individual evolution of the core evolution of the core syndrome of liver stagnation, phlegm heat, blood stasis, spleen deficiency, etc., grasp the key pathogenesis in a timely manner, adhere to the combination of obsession and organic integration, and correct correction as a righteousness. The principle of this sequence consistency refers to the recovery of the corner.

Medical Guidance: Fan Guanjie, a provincial -level famous Chinese medicine medicine, a guidance professor at the National Outstanding Chinese Medicine Clinical Talent, the seventh batch of academic experience inheritance of academic experience in the academic experience of old Chinese medicine experts, chief physicians, doctoral supervisors, postdoctoral cooperative professors.

Good at: integrated Chinese and Western medicine to treat diabetes, diabetic peripheral neuropathy, diabetes and nephropathy and other diabetes complications, as well as endocrine metabolic diseases such as hyperthyroidism, hyperthyroidism, thyroid gland nodules, nailitis and other thyroid diseases, gout, obesity, and hyperlipidemia.

Diagnosis time

Location of the diagnosis

Tuesday afternoon (13: 30-16: 00)

Dade Road General Hospital

Thursday afternoon (13: 30-15: 30)

Fangcun Hospital

Sunday afternoon (13: 30-15: 00)

Gu Shengtang Clinic

Dade Road General Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine: No. 111, Dade Road, Guangzhou City

Fangcun Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine: No. 36 Yong'an Street, Guangzhou

Gu Shengtang Yuexin Clinic: 4th Floor, Moon Jinyu, Changyong Road, Changdi Road, Yuexiu District, Guangzhou

Traditional Chinese medicine is an excellent representative of traditional Chinese culture. The book "Philosophy Traditional Chinese Medicine-" Dynamic-Preface to Fan Fan's Eight Laws "and the clinical thinking of Chinese medicine" uses various mainstream philosophical thinking methods of ancient and modern Chinese and foreign And building is a new attempt for breakthroughs in the theory of Chinese medicine, and it is also a lively example of self -confidence in Chinese culture. The theory of "Chinese Medicine" comes from clinical, and it is higher than the clinic, and instructs clinical use. This book systematically describes Professor Fan Guanjie's clinical medicine ideas and is also a summary of Professor Fan's clinical experience.

Supply: Li Kangli Weihua, Department of Endocrinology, Department of Endocrinology, Guangdong Provincial Hospital of Traditional Chinese Medicine

Executive editor: Wu Yuan Tuan

Audit school pair: Zhuang Yingge

Editor in charge: Song Liping

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