摘要
关于糖尿病胃轻瘫(DGP)的治疗,中医学既往多从升清降浊、辛开苦降等法论治,以调理脾胃气机升降,恢复中焦运化为最终目的.通过探讨胆与脾胃的生理联系及其与DGP的病理联系,认为胆腑同样也参与了机体的血糖控制及消化活动,与该病的发病密切相关.胆为少阳枢机,内藏精汁,内寄相火,主升发疏泄,司决断情志,气血津液的正常运行、脏腑经络的功能活动与胆密切相关.当胆腑功能出现异常时,机体亦会有肠道菌群失调、胃肠激素紊乱、胃排空延迟、血糖升高等改变,这与现代医学对于DGP的发病认识相符合.提出"木郁达之"的治疗原则,随证治疗DGP,为临床治疗提供参考.
Abstract
In the treatment of diabetic gastroparesis(DGP),traditional Chinese medicine has conventionally focused on therapies such as ascending clear and descending turbid,pungent-opening and bitter-descending methods,aiming to regulate the ascending and descending of the spleen and stomach's Qi mechanism and to restore the middle-jiao's transformation as the ultimate goal.By explo-ring the physiological relationship between gallbladder and spleen-stomach and its pathological relationship with DGP,this article sug-gests that the gallbladder also participates in the regulation of blood sugar and digestive activities in the body,which is closely related to the onset of the disease.As the Shao Yang pivot,the gallbladder stores essential fluid,harbors ministerial fire,primarily governs the upward movement and dispersion,and is responsible for decision-making and emotions.The normal flow of Qi,blood,and body flu-ids,as well as the functional activities of the channels and collateral vessels,are closely associated with the gallbladder.When the gallbladder's function becomes abnormal,the body may also exhibit imbalances in the intestinal microbiota,disarray of gastrointestinal hormones,delayed gastric emptying,and elevated blood sugar levels,which aligns with the modern medical understanding of the onset of gastroparesis diabeticorum.Therefore,this article proposes the treatment principle of"venting the wood constraint"and the treatment of DGP according to symptoms,offering a reference for clinical treatment.
基金项目
首都卫生发展科研专项项目(首发2022-2-4131)