九、甲状腺癌术后. Thyroid cancer

2014.11.22    某，男，41岁

西医检查查出甲状腺部位九个结节，切片诊为甲状腺癌，建议切除。患者家属做保守措施，切除两个发生癌变的，其余做中医治疗。另前列腺钙化。患者称无任何感觉，无吞咽异常。纳可、寐好、二便正常，过去一年情绪时有不畅，饮酒多。左腋下痛3-4年。烂脚跟，足跟痛。心脏偶有刺痛。

刻诊：脉沉甚、舌苔腻、口气重，郁闷个性、不喜言谈，发质油腻。舌难伸出。

印象：少阳郁阻，气机不畅、痰火炼而成结节

治则：滋阴软坚、行气化痰祛湿削结

该病人的特点是：右侧甲状腺（thyroid gland）比左侧大1倍多，结节（nodular）大50%。针灸至11.28，腋下痛、烦躁减轻。28号开始服药，至12.17 每早大便，以前大便不正常。脚跟不痛了。至12.26心脏无不适，舌伸出较前长。2015.3.3 B超检查，结节缩小30%左右。2015.4.3 B超检查结节较上月缩小30%左右；2015.5.15 B超结节较上月又缩小30%左右。2015.5.15 B超检查结果，右侧甲状腺达到正常，左侧反倒仍然稍大，右侧结节缩小60%以上，左侧结节从一月份到三月份结节体积增大的速度逐渐放慢，到四月份才开始缩小，至5月份缩小近20%。有B超记录。后病人因故中断治疗。

此病究竟手术是否妥当仍难下结论。但外科手术对产生此病的根源毫无触及，这是肯定的。就像是一个生芽 的土豆，挖去生出的芽，还会有新的冒出，层出不穷，因为这个土豆有生芽的环境。中医可以改变这个环境而最终根除“芽”的产生。



41-year-old male, Nov 22,2014

CT showed nine nodules on both sides of Thyroid. Diagnosed malignant by surgical biopsy. Doctor advised surgery and his wife preferred herbal therapy. As a reconciliation, surgery removed two nodules that looked worse.

History: bad mode in the past few years, drank a lot, pain on armpit of the left arm for like 3-4 years. Cracks and pain on heels.

Current: deep pulses, thick tongue coating, reserved personality, greasy hairs. tongue difficult to stick out. Right thyroid gland is about double the size of the left and nodules larger than 50% than the left.

Impression: phlegm and heat

Principle: soften the nodules and expel the phlegm

Acupuncture applied till Nov 28. pain under the armpit decreased and less fidget. started to take herbal therapy on 28th. Till Dec17, pain in heels gone and daily normal stools. Till Dec 26, tongue could stick out. Mar 3. 2015 Ultrasound showed nodules about 30% smaller, May15, 2015 Ultrasound showed 30% smaller in size than Mar3 and thyroid on the right size shrined to normal size, more than 60% smaller than last year while the growth speed of the nodule on the left slowed down and started to shrink from Apr. Till May totally stopped growing. 

It's hard to say whether the patient made the right choice to remove the two nodules at first. But one thing for sure the surgery didn't affect in any sense the surroundings where the nodules grow. It was like a bud in a potato. You can remove them and they will keep growing because the surrounding remains unchanged.