仝小林运用赤芍、黄柏、生地黄清热降糖疗“瘅”经验  

Professor Tong Xiaolin’s experience in treating the heat syndrome by clearing heat and reducing blood sugar with a minor prescription of three Chinese medicines

作　　者：王涵[1] 吴学敏 杨才佳 顾成娟 WANG Han;WU Xuemin;YANG Caijia;GU Chengjuan(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Tong Xiaolin Famous Doctor Studio,Shenzhen Hospital of Guangzhou University of Chinese Medicine,Shenzhen 518034,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]广州中医药大学深圳医院<福田>仝小林名医工作室,广东深圳518034

出　　处：《吉林中医药》2021年第8期1010-1012,共3页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金重点项目(81430097)。

摘　　要：瘅,即“热”也。现代早中期糖尿病,可分为“脾瘅”与“消瘅”,其中,脾瘅以中满内热为核心病机,而消瘅以肝郁脾虚胃热为核心病机,无论是脾瘅或是消瘅,清热皆为此阶段的澄源之治。赤芍、生地、黄柏合称“凉脺饮”,是仝小林院士常用的清热凉血降糖小方,多用于糖尿病郁热化火,伤阴动血,火热盛极,嚣张肆虐之阶段。赤芍清热凉血,兼能散瘀以保护络脉,生地甘寒凉血滋阴,黄柏苦寒清火降糖。苦寒清胃火,甘寒养胃阴,清热凉血,防火毒耗伤,亦有“早期治络,全程通络”之意。根据热势轻重,方中三味药在临床实际使用中,范围通常在15~30 g之间,若一派火热炽盛,则剂量常以30 g起步。Dan(瘅)fi guratively means heat in traditional Chinese medicine.In modern medicine,diabetes in its early and middle stages can be divided into the syndrome of spleen heat and the syndrome of pure-heat dispersion-thirst,in which the core pathogenesis of the spleen heat syndrome is the fl atulence and endogenous heat,while the core pathogenesis of the syndrome of pure-heat dispersion-thirst is the liver depression,spleen defi ciency and stomach heat.At these two stages of the disease,clearing heat is viewed as the fundamental treatment for either syndrome.Peony root,fresh rehmannia root and amur cork-tree are commonly used in a minor prescription by Academician Tong Xiaolin,referred to as Liangcui Yin,for clearing heat,cooling blood and reducing blood sugar.The prescription is mostly used in the treatment of diabetes with the symptoms of heat depression transforming into fi re,burning stomach yin and consuming blood,fi er-heat extremely intense and rampant.Peony root can clear heat,cool blood,and disperse blood stasis to protect collaterals.Fresh rehmannia root,whose fl avour and nature is sweet and cold,can cool blood and nourish stomach yin.Amur cork-tree,whose fl avour and nature is bitter and cold,can clear fi re and reduce blood sugar.Bitter-cold amur cork-tree clears the stomach fi re,while sweet-cold fresh rehmannia root nourishes the stomach yin,clearing heat and cooling blood,preventing the fi re poison from consuming blood,also bearing the meaning of“treating collaterals in the early stage,clearing collaterals in the whole process”.According to the heat intensity,the dosage range of the three herbs in the prescription is usually 15-30 g in clinical use.If the fi re in either syndrome is intense and rampant,the dosage usually starts at 30 g.

关 键 词：赤芍 黄柏 生地黄 中药降糖 凉脺饮 

分 类 号：R249[医药卫生—中医临床基础]