首页|基于"脾胃转枢"理论探析2型糖尿病的辨证思路

基于"脾胃转枢"理论探析2型糖尿病的辨证思路

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2型糖尿病是较为常见的一种代谢性疾病,发病率呈逐年上升趋势.基于近代糖尿病的相关研究及众多医家的临床治疗思路发现,2型糖尿病脾虚痰湿证在临床中较为常见.脾气虚弱,气化失常,水湿内生,气机失调,久而聚湿成痰,痰性凝滞,痰气互为影响而致本病.针对脾虚痰湿证,各医家的治法或有不同,但大多数治疗从健脾化痰入手,并且取得了一定疗效.通过大量文献研究发现,近代治疗中忽略脾胃气机不利在本病发生发展过程中的作用同样常见.通过大量阅读古医籍中对脾胃理论的研究发现,"脾胃转枢"不利是导致本病发生的重要环节,一方面会导致脾不散精,出现血糖等精微物质吸收、利用障碍,进展为2型糖尿病;另一方面会导致余脏气机失调,阴阳失衡,五脏生理功能失常,加重2型糖尿病病情.在治疗上,除针对基本病机对症治疗,重视脾胃气机升降的正常运转对防治本病有同样重要的意义.针对虚、痰、气机不利进行治疗,基于对"脾胃转枢"理论中治法"调枢五法"的学习,临床用药注重恢复脾胃枢机,取得一定疗效.本研究基于"脾胃转枢"理论探讨气机升降在2型糖尿病脾虚痰湿证进展过程中的重要作用,旨在为临床实现降糖维稳的目标提供较为新颖的诊疗思路.
An analysis of syndrome differentiation thought of type 2 diabetes mellitus based on the theory of spleen and stomach pivot
Type 2 diabetes mellitus is a relatively prevalent metabolic disorder,and its incidence has been increasing year by year.Based on contemporary research and clinical treatment ideas of numerous medical professionals,it is found that spleen deficiency and phlegm-dampness syndrome of type 2 diabetes mellitus is commonly encountered in clinical practice.Weak spleen Qi(气)leads to gasification disorders,internal water and dampness accumulation,and Qi movement imbalances.Long-term accumulation of humidity leads to phlegm generation,the interaction between phlegm stagnant Qi leads to this disease.In view of the spleen deficiency and phlegm-dampness syndrome,different doctors employ diverse treatment methods,the majority of doctors emphasize strengthening spleen and eliminating phlegm,and have obtained positive outcomes.Through a large number of literature studies,it is found that the oversight of the role of unfavorable Qi movement of spleen and stomach in the development of this disease is also common in modem treatment.Investigations into the theory of spleen and stomach reveal that an unfavorable pivot of spleen and stomach is a significant factor contributing to the onset of this disease.On the one hand,the unfavorable pivot of the spleen and stomach can lead to the failure of spleen to dissipate essence,the absorption and utilization of fine substances such as blood glucose,leading to type 2 diabetes mellitus;on the other hand,it can lead to the imbalance of Qi movement of the remaining viscera,the imbalance of Yin(阴)and Yang(阳),and the physiological dysfunction of five Zang organs(五脏),aggravating the condition of type 2 diabetes mellitus.In the treatment,in addition to the symptomatic treatment for the basic pathogenesis,it is also necessary to pay attention to the normal operation of the spleen and stomach Qi movement,which has the same important significance for the prevention and treatment of this disease.For the treatment of deficiency,phlegm and adverse Qi movement,based on the study on the five methods of regulating pivot of the spleen and stomach pivot theory,efforts have been directed towards restoring the spleen and stomach Qi movement,and achieved a certain effect in clinical practice.Based on the spleen and stomach pivot theory,this paper explores the crucial role of ascending and descending of Qi movement in the progression of spleen deficiency and phlegm-dampness syndrome of type 2 diabetes mellitus,aiming at presenting an innovative approach for diagnosis and treatment ideas for the clinical goal of reducing and maintaining blood glucose.

Type 2 diabetes mellitusSpleen deficiency and phlegm-dampness syndromeSpleen and stomach pivotAscending and descending of Qi movementTheoretical analysis

石丹妮、刘绍维、张蒙蒙、李嘉贺、李昕彤、高艺玲、包扬

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长春中医药大学,吉林 长春,130117

长春中医药大学附属医院,吉林 长春,130021

2型糖尿病 脾虚痰湿证 脾胃转枢 气机升降 理论探析

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(31)