基于"有故无殒"理论治疗2型糖尿病并发症经验
Clinical experience in treating complications of type 2 diabetes of through the lens of yougu wuyun
蓝宇洋 1王晓斐 1苗耀东 2吴深涛1
作者信息
- 1. 天津中医药大学第一附属医院 天津 300381;国家中医针灸临床医学研究中心
- 2. 天津中医药大学第二附属医院
- 折叠
摘要
2 型糖尿病(T2DM)归属于中医学"消渴"范畴,其病机纷繁复杂,日久易生他症,渐以虚实相兼、本虚标实为核心特点.对于消渴并发症治疗当攻补兼施,尤以正气大虚、邪实壅盛之时,急当祛邪以扶正,其临床辨治思想与《黄帝内经》中所述"有故无殒"理论核心相同.临床对"毒"分析尤多,不能单纯从药物角度理解"毒"之义,而可理解为"厚"在病情,疾病厚重久笃.消渴病"浊毒内蕴",浊毒之邪循"气—血—脉络"之规律传变,蓄损于正虚之处,致使变证丛生.临床辨治消渴并发症需精确辨证、当机立断,勿忘偏性、中病即止,配伍用药、增效减毒,毒之有道、邪去正安.并结合临床病案对基于"有故无殒"治疗2 型糖尿病并发症经验进行阐述.
Abstract
Type 2 diabetes mellitus(T2DM)is classified under the category of xiaoke(consumptive thirst)in traditional Chinese medicine(TCM).The pathogenesis of T2DM is complex and prone to causing other complications over time,often characterized by a mix of deficiency and excess conditions.Treatment of diabetic complications should address both aspects,especially during periods of severe deficiency of vital energy and abundance of pathogenic factors.This clinical approach aligns with the core principles of yougu wuyun(if there is a hardening,there will be no harm)described in the Huangdi Neijing.In clinical practice,the analysis of"toxins"should extend beyond a pharmacological perspective to encompass the notion of"thickness"in disease,indicating prolonged and severe illness.In T2DM,turbid toxin follows the"qi-blood-collaterals"pathway,accumulating in areas of vital energy deficiency and leading to a proliferation of syndromic changes.Effective clinical management of diabetic complications necessitates precise differentiation,timely intervention,and a balanced approach.Treatment should avoid extremes,cease once the condition stabilizes,and utilize compatible drug combinations to enhance efficacy and reduce toxicity,thereby achieving a harmonious resolution of pathogenic factors and strengthening vital energy.This paper discusses the clinical experience in treating T2DM complications using the yougu wuyun theory,illustrated with case studies.
关键词
有故无殒/2型糖尿病并发症/临证经验Key words
yougu wuyun(if there is a hardening,there will be no harm)/complications of type 2 diabetes/clinical experience引用本文复制引用
基金项目
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)
出版年
2024
国家科技期刊平台
NSTL
万方数据