基于“脾胃转枢”理论分期论治2型糖尿病相关性肌肉减少症  

Staged Treatment of Type 2 Diabetes-related Sarcopenia through the “Transfer Function of Spleen and Stomach Qi” Theory

作　　者：朱建伟 魏凯善 卓兴卫 徐刚 钟文[1] 谢春光[1] 高泓[1] ZHU Jianwei;WEI Kaishan;ZHUO Xingwei;XU Gang;ZHONG Wen;XIE Chunguang;GAO Hong(Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610075)

机构地区：[1]成都中医药大学附属医院,成都610075

出　　处：《中医杂志》2021年第9期768-771,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81804157);四川省中医药管理局科学技术研究专项(2018KF003);成都中医药大学附属医院科技发展基金(2017-D-YY-54)。

摘　　要：2型糖尿病与肌肉减少症(简称肌少症)之间存在着密切的双向关系。脾胃居中央,对全身气机升降运行起着中轴转枢的关键作用,而这种转枢功能的发挥也是脾胃调控糖代谢和骨骼肌系统的重要生理基础。基于"脾胃转枢"理论,认为脾病而"转枢不利"是2型糖尿病相关性肌少症的核心病理环节,调畅脾胃枢机是治疗2型糖尿病相关性肌少症的核心。提出分期治疗,初期以气郁脾胃为主,治宜开郁运脾;中期以脾虚络阻为主,治宜扶脾通络;晚期以脾肾亏虚为主,治宜补脾固本。There is a close bidirectional relationship between type 2 diabetes and sarcopenia. It is known that the spleen and stomach are staying in the center, and play a key role in qi movement including ascending, descending, circuiting and transporting, which lay the foundation for the physiological theory of spleen and stomach to regulate glucose metabolism and skeletal muscle system. Based on the "transfer function of spleen and stomach qi" theory, it is believed that the disturbance of qi movement due to spleen dysfunction is the core pathological mechanism of sarcopenia in type 2 diabetes, and therefore the therapeutic method of regulating spleen and stomach pivot should be implemented. Staged treatment should be performed in accordance with the development of disease;in the early stage when spleen and stomach qi stagnation is predominated, it is recommended to resolve constraint and activate spleen;in the middle stage when spleen deficiency and collateral obstruction is predominated, the method of supporting spleen and unblocking collaterals should be adopted;in the late stage when spleen-kidney depletion and deficiency is mainly manifested, it is suggested to supplementing spleen and consolidating the root.

关 键 词：2型糖尿病 肌肉减少症 脾胃转枢 

分 类 号：R259[医药卫生—中西医结合]