基于中医脏象理论构建消渴治疗框架  

Treatment Framework for Diabetes Based on Traditional Chinese MedicineTheory of Visceral

作　　者：陈胡蓉 杨宇峰[1] 董世彦 石岩[1] CHEN Hu-rong;YANG Yu-feng;DONG Shi-yan;SHI Yan(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China)

机构地区：[1]辽宁中医药大学,沈阳110847

出　　处：《中国实验方剂学杂志》2020年第11期200-205,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点基础研究发展计划(973计划)项目(2013CB532004);辽宁省高等学校创新团队基金项目(LT2014020);辽宁省自然科学基金项目(20170540598)。

摘　　要：糖尿病作为最常见的慢性非传染性疾病之一,发病率逐年升高,随着病程延长还可导致眼、肾、神经、心脏、血管等多组织器官损伤,严重危害人类健康。中医药防治糖尿病临床优势突出,具有鲜明的诊疗特色。祖国医学对糖尿病的认识源远流长,近年来在病因、病机和治疗方面的研究也正逐步深入,取得了一定的进展。早在《黄帝内经》中就有“五脏皆柔弱者,善病消瘅”的记载,提示糖尿病的发生与五脏皆有关。通过收集整理消渴相关古籍文献,按照中医理论框架“集成-归真-纳新”的基本构建原则,基于中医脏象理论,分析五脏虚损致消的病因病机多为肝脏虚弱,失于疏泄,情志失常郁而化火;心脏虚弱,心阴耗伤,内生燥热;脾脏虚损,失于健运而运化失常;肺脏虚弱,燥热之邪伤肺,津液失于输布;肾脏虚弱,肾阴亏虚,固摄无权,气化无力不能维持体内津液代谢平衡。总的来说为阴虚热盛。以五脏为空间维度构建消渴治疗框架。总结出消渴的治则治法主要有疏肝理气、调畅情志,清泻心火、滋阴润燥,升补脾阳、健脾除湿,清肺润燥、养阴生津,滋阴补肾、温肾助阳等。通过构建结构清晰、层次分明的理论框架,旨在搭建起中医理论与中医临床实践之间的桥梁,以期为中医古籍文献研究及中医药治疗糖尿病提供新思路,为中医理论的传承与发展尽绵薄之力。Diabetes is one of the most common chronic non-communicable diseases. The incidence rate is on the increase year by year. As the disease progresses,it can cause damages to many tissues and organs,such as eyes, kidneys, nerves, heart and blood vessels, which seriously endangers human health. Traditional Chinese medicine(TCM)has outstanding clinical advantages in the prevention and treatment of diabetes,with distinctive characteristics of diagnosis and treatment. TCM has a long history of understanding diabetes. In recent years,researches on etiology,pathogenesis and treatment have gradually deepened and made certain progress. As early as in the Huangdi Neijing,there is a record of "If people’s lung,spleen viscera(stomach),liver,kidney are weak,they can easily get diabetes". This paper collected and summarized ancient literatures relating to diabetes. According to the basic construction principle of "integration-authenticity-innovation" in the theoretical framework of TCM,the causes of the disease include liver weakness and failure in dredging and regulation,emotional disorder,endogenous heat and dryness,heart weakness,heart Yin depletion,endogenous dryness and heat,spleen deficiency and failure in transportation and transformation,lung injury caused by dryness and heat, dysfunction of body fluid distribution, kidney Yin deficiency, astringent weakness,insufficient Qi transformation for maintaining body fluid metabolism balance. In general,Yin deficiency is the root cause,and dryness and heat are the appearance. A framework for the treatment of diabetes was built with five organs as spatial dimension. This paper summarizes the etiology and pathogenesis of diabetes caused by viscera deficiency,with the treatment of diabetes with the five internal organs as the basic framework. The main methods of treating diabetes are relieving Qi stagnancy in liver,regulating the mood,clearing the heart fire,Yinenriching and dryness-moistening, reinforcing spleen Yang, invigorating spleen and removing dampness,clearing lung and m

关 键 词：脏象理论 消渴 治疗框架 中医理论 糖尿病 

分 类 号：R255.4[医药卫生—中医内科学] R22[医药卫生—中医学]