首页|结合一则医案再思考《黄帝内经》"治之以兰"法治疗糖尿病的内涵

结合一则医案再思考《黄帝内经》"治之以兰"法治疗糖尿病的内涵

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"治之以兰"始载于《素问·奇病论篇》,本意为利用兰草"除陈气",是当时针对消渴病提出的治法.消渴病类似于现代医学中的糖尿病,一种以慢性高血糖为主要表现的代谢性疾病,其特征是胰岛素绝对或相对缺乏和(或)靶器官胰岛素抵抗,进而引起多系统损害,病情严重时可对患者的生活质量造成重大不良影响.糖尿病的病因病机十分复杂,中医学认为其发生发展与多种因素有关,病机以阴虚为本、燥热为标,似与"治之以兰"无甚关联.研究梳理中医经典著作中诸医家对糖尿病的认识,结合一例医案再思考《黄帝内经》中对糖尿病"治之以兰"的内涵.经过对中医经典和临床案例的分析,认为"治之以兰"实际上是示人以法,是糖尿病全病程中的概括性治法,本质是疏通气机,继而调节脏腑功能,"以辛能发散故也".
The connotation of treating diabetes with aromatic eliminating-dampness drugs such as Lan in Huangdi Neijing with one empirical case
According to the record,"Treating diseases with Lan(Herba Eupatorii)"was originally written in The Chapter on Qibing Lun of Suwen(《素问·奇病论篇》),which meant to use Lan to remove stale odour.This therapy was proposed to treat Xiaoke(消 渴)disease at that time.Xiaoke disease is now known as diabetes in Western medicine.Diabetes is similar to diabetes in modern medicine.Diabetes is a metabolic disease mainly manifested by chronic hyperglycemia,which is characterized by absolute or relative lack of insulin and/or insulin resistance in target organs,can lead to multi-system damage,and cause significant adverse effects on the quality of life of patients in severe cases.The etiology and pathogenesis of diabetes mellitus is very complex.Traditional Chinese medicine believes that the occurrence and development of diabetes mellitus are related to a variety of factors,its pathogenesis is characterized by Yin(阴)deficiency,taking dry-heat as exterior symptom,which seems to have nothing to do with"Treating diseases with Lan".This article sorts out the understanding of TCM practitioners on diabetes in the classic works of traditional Chinese medicine,and reconsiders the connotation of"Treating diseases with Lan"in the treatment of diabetes in Huangdi Neijing(《黄帝内经》)with one medical case.By the analysis of TCM classics and clinical cases,it is believed that"Treating diseases with Lan"is actually a presentation of treatment methods,and is a generalized treatment method for diabetes mellitus.Its essence is to dredge Qi movement(气机),then regulate the function of viscera because of the divergence function of the spicy taste.

Treating diseases with LanDiabetesTraditional Chinese medicine

谢越、郭际、赵海亮、叶文

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上海中医药大学附属光华医院,上海,201203

广州中医药大学,广东 广州,510000

治之以兰 糖尿病 中医

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(25)