〔摘要〕 桥本甲状腺炎(Hashimoto thyroiditis， HT)是一种慢性自身免疫性的甲状腺疾病，病理特征是淋巴细胞浸润，导致甲状腺逐渐萎缩和纤维化，早期因甲状腺滤泡性细胞过度破坏，可出现甲状腺功能亢进，最终可因耗竭导致甲状腺功能减退。该病发病较隐蔽，发病率高，难以根治，西医缺乏有效的治疗方案，长期服用甲状腺激素补充治疗容易出现心慌、骨质疏松等不良反应。龚旭初教授认为，本病发病机制多为脾肾阳虚、肝脾失衡，病理因素为气滞、痰凝、血瘀，病性为本虚标实。治疗上承袭陈实功“外科正宗”学术思想，结合HT的病机特点，将疮疡病“消、托、补”三法用于该病的不同阶段，强调根据患者的症状、体征、甲状腺激素及抗体水平分期辨证论治，酌情配合西医治疗，可缩短疾病治疗周期，降低复发，临床疗效好，值得推广。

    〔关键词〕 消法；托法；补法；桥本甲状腺炎；《外科正宗》；学术经验；龚旭初

    〔中图分类号〕R249" " " " "〔文献标志码〕A" " " " " 〔文章编号〕doi：10.3969/j.issn.1674-070X.2025.03.026

    GONG Xuchu's experience in staged treatment of Hashimoto thyroiditis with three methods of \"resolving， supporting， and tonifying\"

    CHEN Haidong， GONG Xuchu*

    Nantong Hospital Affiliated to Nanjing University of Chinese Medicine， Nantong， Jiangsu 226001， China

    〔Abstract〕 Hashimoto thyroiditis (HT) is a chronic autoimmune thyroid disease characterized pathologically by lymphocyte infiltration， leading to gradual atrophy and fibrosis of the thyroid gland. In the early stages， due to excessive destruction of thyroid follicular cells， hyperthyroidism may occur， ultimately progressing to hypothyroidism as a result of thyroid depletion. The onset of the disease is insidious ......