原发性甲状腺功能减退症是一种自身免疫性甲状腺疾病,近年来发病率增加.随着细胞学检查和血清抗体水平测定的应用,该病的诊断率逐渐提高,引起了医生和患者的广泛重视.本文从中西医角度探讨原发性甲状腺功能减退症的发病原因,以提高广大医师对该病的知晓度,实施积极的健康管理方案,达到维护民众健康福祉的目的.中医认为,原发性甲状腺功能减退症病机为脾肾阳虚、气滞血瘀、痰浊内停、蒙蔽心窍.西医确诊甲状腺功能减退症的方法是检测血清促甲状腺激素(TSH)水平.该病的致病因素除自身免疫疾病、甲状腺部分切除、先天性甲状腺功能减退、甲状腺炎、药物外,还受到碘、硒、维生素D缺乏及病毒感染等因素的影响.虽然目前该病不能被治愈,但大多数患者的病情是可以控制的.西医通常采用甲状腺素补充疗法;中医认为加复方中药汤剂或丸剂治疗效果更明显;原发性甲状腺功能减退症患者还应反应进行血液检测,以使TSH保持在参考范围.目前研究认为,大多数原发性甲状腺功能减退症患者需终生服药.今后有必要融入多学科的研究方法,促进前沿研究的开展.%Recently, the prevalence of primary hypothyroidism,an autoimmune thyroid disease, has been increasing. Part of this increase can be attributed to the introduction of cytological examinations and serum antibody tests. Much attention has been paid to this increase by both doctors and patients. This paper discusses the pathogenesis of primary hypothyroidism in the context of traditional Chinese and Western medicine, with the aims of improving public awareness of the disease, and implementing active health management schemesto achieve the goal of maintaining public health and wellbeing. According to traditional Chinese medicine, primary hypothyroidism is attributed to Yang deficiency of the spleen and kidney, Qi stagnation,blood stasis, turbid phlegm, retention of food, and a blind mind. In Western medicine, detection of serumthyroid-stimulating hormone (TSH) is used to diagnose hypothyroidism. In addition to autoimmune diseases, hypothyroidism can result from partial removal of the thyroid gland,congenital hypothyroidism, thyroiditis, drug use, viral infections, and deficienciesiniodine, selenium, and vitamin D. Currently, primary hypothyroidismcannot be cured, however, most cases are controllable. Treatment mainly comprises of thyroxine supplementation. The addition of Chinese medicines are believed to achieve improved therapeutic efficacy. Additionally, repeated blood testing is recommendedinprimary hypothyroidismcases to ensure that normal TSH levels are maintained. It is accepted that most patientswith primary hypothyroidism require life-long drug therapy, therefore, multidisciplinary approaches should be employed to facilitate the collaborationand discussion of future cutting-edge research.
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