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基于《黄帝内经》核心观念探析消渴病证治思路

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消渴病在《黄帝内经》中论述较多,《素问·奇病论篇》将其归属于"奇病"范畴,体现了消渴病的难治性。本文基于《黄帝内经》核心观念认识、探析消渴病。首先,从《黄帝内经》象思维方法切入,认识到消渴病可以导致人体内在气象的变动;再以《黄帝内经》精气学说、阴阳学说、五行学说为指导,解构、分析消渴病导致气象变动的原因及精气的气化规律,认为消渴病的变动气象为"热象"。"热象"引发之因主要为脾虚湿盛,其气化规律为少阴热化,其难治性主要体现在五行失衡导致的"热象"无制。基于对消渴病热象的认识,提出消渴病以化湿调脾预防疾病、调和肾气防止传变及阴阳皆调治疗久病不愈的证治思路,以期为优化消渴病的治疗提供参考。
Discussion the syndrome and treatment of consumptive thirst based on the core concept of Huangdi Neijing
Consumptive thirst is widely discussed in Huangdi Neijing and it is classified as a"strange disease"in Suwen·Strange Diseases Treatise,which reflects the intractable nature of consumptive thirst.This paper explores and analyzes consumptive thirst based on the core concept in Huangdi Neijing.First,this paper approaches the subject through the use of image thinking method from Huangdi Neijing,recognizing that consumptive thirst can lead to changes in the internal climate of the human body.Then,guided by the theories of essence and qi,yin and yang,and the five elements in Huangdi Neijing,it deconstructs and analyzes the causes of these changes and the laws of qi transformation.It points out that the changing climate of consumptive thirst is characterized by"heat symptoms".The main cause of"heat symptoms"is spleen deficiency and excessive dampness,and its qi transformation law is the heat transformation of Shaoyin.The intractable nature of consumptive thirst is mainly reflected in the uncontrolled"heat symptoms"caused by the imbalance of the five elements.Based on the understanding of the heat symptoms of consumptive thirst,this paper proposes a treatment strategy for preventing the disease by resolving dampness and regulating the spleen,harmonizing kidney qi to prevent progression,and balancing yin and yang to treat chronic and recalcitrant conditions.The aim is to provide a reference for optimizing the treatment of consumptive thirst.

consumptive thirstcore conceptdiabetes mellitusheat symptomsHuangdi Neijing

田栋、廖书琴、佟常青、张潇逸、曹娜、王维广、陈子杰、翟双庆

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北京中医药大学中医学院 北京 100029

北京中医药大学东直门医院

消渴病 核心观念 糖尿病 热象 黄帝内经

国家重点研发计划国家重点研发计划

2018YFC17041002018YFC1704105

2024

北京中医药大学学报
北京中医药大学

北京中医药大学学报

CSTPCD北大核心
影响因子:1.568
ISSN:1006-2157
年,卷(期):2024.47(6)