关键词: 饮食, 饮食模式, 自身免疫性甲状腺炎, 范围综述, 治疗策略

Abstract: Background Autoimmune thyroiditis (AIT) is the leading cause of thyroid dysfunction, significantly affecting patients' quality of life. In recent years, dietary patterns as potential pathways to regulate immunity and metabolism have attracted considerable attention. However, there is a lack of systematic summaries regarding their clinical effectiveness and individualized application strategies. Objective This study employed a scoping review approach to systematically assess the impact of different dietary patterns on AIT and propose individualized treatment strategies, providing evidence-based guidance for clinical practice. Methods Databases including CNKI, PubMed, and Web of Science were searched for relevant literature from their inception to March 2025. A total of 23 studies (including 12 randomized controlled trials) were included, covering nine dietary patterns such as gluten-free diet, Mediterranean diet, and low-carbohydrate diet. Two researchers independently screened the literature and extracted data, and recommendations were made based on the quality of evidence and clinical applicability. Results The gluten-free diet (GFD) and the Mediterranean diet (MD) are the two interventions with the highest evidence support for AIT patients with coeliac disease and metabolic abnormalities, respectively (Grade B recommendation). Low-carb diets, anti-inflammatory diets, and autoimmune protocol diets have shown potential benefits in specific populations, but the overall evidence grade is C or D. The individualized treatment strategy should be combined with the immune status, metabolic characteristics and dietary compliance of patients, and establish a dynamic individualized management path with "assessment - decision - intervention - monitoring" as the core. Conclusion Dietary intervention is an effective complementary means for the comprehensive treatment of AIT. At present, GFD and MD are recommended as the preferred basic intervention strategies, and are applied precisely according to the individual characteristics of patients. Other dietary patterns should be used as complementary interventions based on professional assessment. In the future, multi-center and long-term studies are needed to optimize the synergistic effect of diet, drugs and nutrients, and explore the mechanism of gut microbiota-immune axis, so as to promote the application of precision medicine in AIT.

Key words: Diet, Dietary patterns, Autoimmune thyroiditis, Scoping review, Therapeutic strategy