Syndrome Differentiation and Treatment of Thyroid Nodules with Hyperactivity of Liver Fire and Yin Deficiency of Heart and Liver

Strong liver fire: slight or moderate swelling in front of the neck, mild or moderate swelling and protruding on both sides of the Adam's apple in front of the neck compared with normal people, generally soft and smooth, trembling fingers, burning sensation on the face, annoyance, hunger, exophthalmos and sweating. Or bitter mouth and dry throat, want to drink cold water, dry stool; Or dizzy; Or flustered, chest tightness, or insomnia. Red tongue with yellow fur and thin pulse.

Pathological mechanism: liver depression and qi stagnation, qi stagnation into fire.

Treatment method: clearing liver and purging fire, eliminating galls and resolving hard mass.

The prescription is Longdan Xiegan Decoction and Wei Qing Powder, and the medicines are: Radix Gentianae, Rhizoma Anemarrhenae, Fructus Gardeniae, Scutellariae Radix, Radix Rehmanniae, Gypsum Fibrosum, Cimicifuga Rhizoma, Cortex Moutan, Fructus Forsythiae, Rhizoma Polygonati Odorati, Sargassum, Coptidis Rhizoma, Os Draconis, Concha Ostreae, Uncaria and Chenopodium.

People with dry stools will increase Huangpi and Magnolia officinalis; Radix Angelicae Dahuricae and Rhizoma Acori Graminei are added for eyeball soreness; Semen Platycladi and Semen Ziziphi Spinosae are added for severe palpitation.

Yin deficiency of heart and liver: swelling and softness in front of neck, big or small, slow onset, palpitation and sweating, restless sleep, dry eyes, rotation of vision, trembling fingers, dizziness and fatigue, and dull pain in chest and hypochondrium; Or eat too much but still get hungry easily, and the body is thin; Or after the woman's menstruation is irregular, the amount is small; Or amenorrhea. The tongue is red, or the tongue body vibrates, with little or no coating, and the pulse is thin and thin.

Pathological mechanism: Qi-fire intrinsic, heart-liver yin deficiency.

Treatment: nourishing yin to reduce fire, calming the heart and softening the liver.

The prescription is Tianwang Buxin Dan Guan Yi Decoction, and the drugs are Ginseng, Scrophularia, Radix Rehmanniae, Ophiopogon japonicus, Radix Asparagi, Radix Angelicae Sinensis, Radix Paeoniae Alba, Semen Platycladi, Fructus Schisandrae Chinensis, Poria, Fructus Lycii, Fructus Toosendan and Ramulus Uncariae cum Uncis.

Rhizoma Dioscoreae, Rhizoma Atractylodis Macrocephalae, Coicis Semen and Fructus Hordei Germinatus are added for loose stools and frequent stools; Plastrum Testudinis, Herba Taxilli, Semen Cuscutae and Radix Cyathulae are added for soreness of waist and knees; Radix Astragali and Colla Corii Asini are added for patients with deficiency of both qi and blood; Semen Ziziphi Spinosae, Os Draconis and Radix Polygalae can be added for patients with severe palpitation.

In addition, if patients with hyperthyroidism and/or thyroid autoantibodies are significantly increased, it is recommended to avoid taking Chinese medicine containing iodine. The above drugs should be taken under the guidance of a doctor.

I'm Zhang Shefeng, an endocrinologist. Pay attention to me and learn more about health.