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.

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.

Databases including CNKI, PubMed, and Web of Science were searched for relevant literature for studies on the effects of different dietary patterns on AIT, from their inception to March 1, 2025. A total of 23 studies(including 12 randomized controlled trials) were included, covering dietary patterns such as gluten-free diet (GFD), Mediterranean diet (MD), 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.

The GFD and the MD were 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 had shown potential benefits in specific populations, but the overall evidence grade was C or D. An individualized treatment strategy should consider the patient's immune status, metabolic characteristics, and dietary adherence, establishing a dynamic individualized management pathway.

Dietary intervention plays an important complementary role in the comprehensive treatment of AIT. Given the robust evidence, GFD and MD are recommended as the primary basic intervention strategies, which should be precisely applied according to the individual characteristics of patients in clinical practice. Other dietary patterns may have value in specific populations but lack high-quality evidence support. In practical applications, it is essential to comprehensively evaluate the patient's immune status and metabolic characteristics to develop individualized treatment strategies, thereby enhancing therapeutic efficacy and adherence.

自身免疫性甲状腺炎（AIT）是甲状腺功能障碍的首要病因，严重影响患者的生活质量，近年来饮食模式作为潜在调节免疫与代谢的途径备受关注，但其临床有效性及个体化应用策略尚缺乏系统总结。

本研究采用范围综述方法，系统评估不同饮食模式对AIT的影响，并提出个体化治疗策略，为临床实践提供循证依据。

检索中国知网、PubMed、Web of Science等数据库中建库至2025-03-01发表的不同饮食模式对AIT影响的文献，依据纳入与排除标准，共纳入23项研究（含12项随机对照试验），涵盖无麸质饮食（GFD）、地中海饮食（MD）、低碳水化合物饮食等模式。由2名研究者独立筛选文献并提取数据，结合证据质量和临床适用性进行分级推荐。

GFD和MD为证据支持度最高的两种干预模式，分别适用于合并乳糜泻和代谢异常的AIT患者（B级推荐）。低碳水化合物饮食、抗炎饮食、自身免疫协议饮食等虽在特定人群中展现潜在效益，但整体证据等级为C或D级。个体化治疗策略需结合患者免疫状态、代谢特征及饮食依从性，构建动态个体化管理路径。

饮食干预在AIT综合治疗中具有重要补充作用。GFD和MD因较高的证据支持，建议作为首选基础干预策略，在临床实践中应结合患者个体特征精准应用。其他饮食模式在特定人群中可能具有一定价值，但缺乏高质量研究支撑。在实际应用中，需综合评估患者免疫状态和代谢特征，制订个体化治疗策略，以提升疗效和依从性。