首页|马万千基于脏腑相关理论辨治糖尿病思想经验

马万千基于脏腑相关理论辨治糖尿病思想经验

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糖尿病归属于中医消渴范畴,为临床常见病,消渴首见于《素问·奇病论》.马万千主任医师是全国基层老中医传承工作室指导老师,从事中医临床工作40 余年,在消渴诊治方面具有独到见解.马万千基于脏腑相关理论,根据肺胃、肺肾、肝脾、肝肾、脾胃等脏腑相关病变进行脏腑同治,指出消渴初期多为阴虚燥热,日久则耗伤气血津液,进而阴损及阳,致使阴阳两虚,主张将糖尿病分为气阴两虚、肺胃燥热、肝肾阴虚、肝郁脾虚、脾胃虚弱、脾虚胃热、阴阳两虚7 个证型,并结合湿热、热毒、痰浊、瘀血兼证进行论治,辨证选用生脉饮合消渴方、益胃汤、六味地黄丸、四逆散、补中益气汤、三黄清幽汤、右归饮等为主方,随证加减,临床疗效显著.本文对马万千辨治糖尿病的思想及经验进行系统总结及阐述,并附验案一则,以期为糖尿病的辨治提供新思路.
MA Wanqian's thought and clinical experience in treating diabetes based on the theory of Zang-fu
Diabetes is classified as Xiaoke in traditional Chinese medicine,Xiaoke was first mentioned in the《Su Wen·The Theory of Extraordinary Diseases》,is a common clinical disease.MA Wanqian,the chief physician of the National Grassroots Institute of Traditional Chinese Medicine,has been engaged in clinical work for more than 40 years and has unique insights into the diagnosis and treatment of Xiaoke.Based on the theory of visceral correlation,MA Wanqian treats the related viscera such as lung and stom-ach,lung and kidney,liver and spleen,liver and kidney,spleen and stomach together.He points out that Xiaoke in its early stage is mostly due to yin deficiency and dryness-heat,which can lead to consumption of qi,blood,body fluids and eventually yin damage to yang,resulting in dual deficiency of yin and yang.He advocates classifying diabetes into seven syndrome types:dual deficiency of qi and yin,dryness-heat in lung and stomach,yin deficiency and kidney-yin deficiency,liver depression and spleen deficiency,spleen and stomach weakness,spleen deficiency and stomach heat,and dual deficiency of yin and yang.In addition,he combines dampness-heat,toxic heat,phlegm turbidity,and blood stasis with syndrome differentiation to treat them accordingly.He selects Shengmai Yin combined with Xiaoke Formula,Yiwei Decoction,Liuwei Dihuang Pill,Sini Powder,Buzhong Yiqi Decoction,Sanhuang Qingyou De-coction,Yougui Yin,etc.as the main prescriptions for syndrome differentiation and modification.The clinical curative effect is re-markable.This article systematically summarizes and expounds the thoughts and experiences of MA Wanqian in the diagnosis and treatment of diabetes mellitus,with one case study attached,in order to provide new ideas for the diagnosis and treatment of diabetes mellitus.

diabetesXiaoke in TCMzang-fu theoryTCM doctor's experience

孙颂歌、刘明宇、张宏阳、马万千、邱新萍、左瑞菊

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北京中医医院顺义医院 101300

北京中医药大学第三临床医学院 100029

北京市顺义区牛栏山社区卫生服务中心 101300

糖尿病 消渴 脏腑相关理论 名老中医经验

马万千全国基层名老中医药专家传承工作室建设项目全国中医药创新骨干人才培训项目

国中医药人教教育便函[2017]325号国中医药人教函[2019]128号

2024

中国老年保健医学
中国老年保健医学研究会

中国老年保健医学

影响因子:0.637
ISSN:1672-4860
年,卷(期):2024.22(1)
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