Differentiation and treatment of Hashimoto thyroiditis based on the theory of "qi cycle in round"

The theory of "qi cycle in round" originates from HUANG Yuanyu′s Sisheng Xinyuan, which takes qi monism as the philosophical foundation, and constructs a qi circulation system with the spleen and stomach as the hub, linking the liver, heart, lung, and kidney on the basis of the gasification theory of Huangdi Neijing. Based on theory of "qi cycle in round," the pathogenesis of Hashimoto thyroiditis begins with liver depression, leading to liver and spleen imbalance, which in turn develops into spleen and kidney deficiency. In the treatment, guided by the principle of "treating same disease with different methods," combined with objective indicators such as the thyroid function, autoantibody, and ultrasound imaging characteristics, Hashimoto thyroiditis was treated in three stages: early, middle, and late stages. In the early stage, characterized by liver depression and qi stagnation, therapy focuses on regulating wood qi to facilitate the pivot; in the middle stage, marked by liver depression and spleen deficiency, and the method of pungent opening and bitter descending should be adopted to restore the ascending and descending of the spleen and stomach; in the late stage, characterized by spleen and kidney yang deficiency, treatment aims to warm the kidney and tonify the spleen, which helps "qi cycle in round" and restores the normal state of qi transformation of zang-fu viscera. Stage-specific differentiation and treatment aims to restore the qi transformation of zang-fu viscera, promote "qi cycle in round," improve thyroid function, and delay the progression of Hashimoto thyroiditis, thereby providing insights and methods for clinical differentiation and treatment of this disease.