瘿病
Alias甲状腺病
Traditional Chinese Medicine Definition
In traditional Chinese medicine, the condition known as "Goiter" is referred to as thyroid disease, which falls under the category of liver and gallbladder disorders. The classical text "Internal Medicine of Traditional Chinese Medicine" records: "The goiter is a mass in the anterior neck, resembling a pendant pearl, with no change in skin color, and it is not painful when pressed. Its size fluctuates with joy and anger." The goiter is characterized by a swelling mass on both sides of the laryngeal prominence in the anterior neck, with the pathological mechanism involving qi stagnation, phlegm accumulation, and blood stasis.
In clinical practice of traditional Chinese medicine, the core pathogenesis of goiter is often associated with liver depression and qi stagnation, phlegm-dampness aggregation, and blood stasis. Common precipitating factors include emotional disturbances, irregular diet, and水土不服. During the process of differentiation, it is important to distinguish between cold and heat, deficiency and excess, such as the qi stagnation and phlegm obstruction pattern, which presents with soft goiter masses in the anterior neck that are not painful and change with emotional fluctuations; the phlegm mass and blood stasis pattern, which is characterized by harder masses and discomfort in the chest; and the liver fire hyperactivity pattern, which is accompanied by symptoms like restlessness and irritability. In terms of treatment, traditional Chinese medicine advocates for regulating qi and alleviating depression, resolving phlegm and reducing goiter, promoting blood circulation and removing blood stasis, and clearing liver fire. By adjusting the functions of the internal organs, balancing yin and yang, and regulating qi and blood, the goal of treating goiter is achieved.
Common Syndrome Types and Key Points of Differentiation
气郁痰阻证
Main Manifestations：颈前喉结两旁结块肿大，质软不痛，随情志消长
Management Approach：理气舒郁，化痰消瘿
痰结血瘀证
Main Manifestations：颈前肿块经久不消，按之较硬，胸闷
Management Approach：理气活血，化痰消瘿
肝火旺盛证
Main Manifestations：颈前喉结两旁轻度或中度肿大，烦热易怒
Management Approach：清肝泻火，散结消瘿
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
For patients with goiter, the size and texture of the neck mass are important indicators for determining the presence of phlegm-dampness, qi stagnation, and blood stasis.
— 李明久 中医执业医师
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This page is for the popular science of traditional Chinese medicine knowledge and does not constitute medical advice. Specific diagnosis should be completed by a licensed traditional Chinese medicine practitioner in person.
参考文献：《中医内科学》（十三五规划教材）、《中医病证诊断疗效标准》(ZY/T001.1-94)、《中医病证分类与代码》(GB/T 15657-2021)