基于“火热论”探讨“胰岛素抵抗-胰岛β细胞缺陷-高血糖-2型糖尿病”网  

Discussion on network of ’insulin resistance-pancreatic beta cell defect-hyperglycemia-T2DM’ based on ’fire-heat theory’

作　　者：曹泽标 刘超男[1] 王保华[1] 徐笋晶[1] 李赛美[1] CAO Ze-biao;LIU Chao-nan;WANG Bao-hua;XU Sun-jing;LI Sai-mei(Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学

出　　处：《中华中医药杂志》2019年第8期3668-3671,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：广东省名中医传承工作室(No.粤中医办函[2018]5号);国家自然科学基金项目(No.81803958);广东省科技计划(No.2014A020221036);广东省教育厅项目(No.2016KQNCX021);广州市科技计划(No.201804010277)~~

摘　　要：文章基于李赛美教授辨治2型糖尿病(T2DM)的“火热论”思想,针对“胰岛素抵抗-胰岛β细胞缺陷-高血糖-T2DM”网进行探讨,提出火热由高血糖积聚产生,可独燃可抱团,常由实渐虚,由三阳入三阴;以脾肾肝脆弱、浊瘀蒙蔽为特征的胰岛素抵抗是火热孕育的条件;而火热的发生发展,则取决于重在三阴的β细胞的阴阳变化;T2DM的宏、微观证候相关,综合判断有利于火热的分类诊断;以该网中的元素为靶点,根据标本邪正,整体辨治,有助于实现火热的精准治疗。Based on professor LI Sai-mei’s‘fire-heat theory’treating type 2 diabetes mellitus(T2DM),we put forward some views on the network of‘insulin resistance-pancreatic beta cell defect-hyperglycemia-T2DM’.The fire-heat is generated by hyperglycemia,and it can fire independently or combining with substantial pathogen from excess to deficiency as well as from three yang to three yin.Then,insulin resistance,characterized by fragility of spleen,kidney and liver,and turbidity and static blood,is the condition of fire-heat breeding.However,the occurrence and development of the fire-heat depend on the yin and yang changes of beta cells mainly under influence of the three yin.Moreover,the macroscopic and microscopic syndromes of T2DM are related closely,so comprehensive collection and judgement are helpful for classification diagnosis of fire-heat.Finally,it is conducive to achieve the precise treatment of‘fire-heat’,by targeting the elements in the network,according to the overall syndrome differentiation and treatment,and the performance,root,vital qi and pathogen.

关 键 词：火热论 2型糖尿病 胰岛素抵抗 胰岛β细胞缺陷 

分 类 号：R58[医药卫生—内分泌]