从虚实变化探讨糖尿病心肌病  

Discussion on treating diabetic cardiomyopathy from the change of deficiency and excess

作　　者：张学林 董惠洁 刘虹瑞 王兼 杨艳文 苏润泽 ZHANG Xuelin

机构地区：[1]山西中医药大学,山西太原030024 [2]山西中医药大学附属中西医结合医院,山西太原030013

出　　处：《中医临床研究》2023年第5期65-68,共4页Clinical Journal Of Chinese Medicine

摘　　要：糖尿病心肌病是糖尿病较为严重的并发症,属于糖尿病的一种独立病证。临床诊断糖尿病心肌病比较困难,因为糖尿病患者往往同时合并有高血压病、冠状动脉粥样硬化性心脏病,而高血压病和冠状动脉粥样硬化性心脏病也可以引起类似于糖尿病心肌病的症状。目前对于糖尿病心肌病的发病机制,并没有完全清楚。现代医学并无特效的疗法,以对症治疗为主,中医的整体观念上有其明显的治疗优势。在糖尿病心肌病早期阶段做到未病先防,中期既病防变,晚期病后防复。同时结合西医的诊疗方法,借助现代社会医学的高科技手段,注重中西医结合优势,为中医学准确的辨证提供服务,更好地发挥中医治疗优势。中医认为,糖尿病心肌病是消渴日久累及于心的临床表现,归属于“心悸”“胸痹”等范畴。根据发病特点和病因病机发现,“虚证”伴随糖尿病心肌病的全过程。因此,从虚和实辨证论治对指导糖尿病心肌病的中医临床诊疗有较为重要的意义。文章从虚与实整体角度,探讨治疗糖尿病心肌病方法,为预防和延缓糖尿病心肌病拓展思路。Diabetic cardiomyopathy is a more serious complication of diabetes,which is an independent disease of diabetes.It is more difficult to diagnose diabetic cardiomyopathy clinically,because diabetic patients often have both hypertension and coronary heart disease,and hypertension and coronary heart disease can also cause symptoms similar to diabetic cardiomyopathy.At present,the pathogenesis of diabetic cardiomyopathy is not fully clear.Modern medicine does not have a specific treatment,focusing on symptomatic treatment,and the overall concept of TCM has its obvious therapeutic advantages.In the early stage of diabetic cardiomyopathy,it should be prevented before the disease,the mid-stage disease should be prevented during the disease,and the advanced disease should be prevented after the disease.At the same time,combined with the diagnosis and treatment methods of Western medicine,with the help of high-tech means of modern social medicine,the advantages of the integrative medicine were pay attention to,providing services for accurate differentiation of TCM,and better playing the advantages of TCM in treatment.According to TCM medicine,diabetic cardiomyopathy is a clinical manifestation of prolonged thirst loss and heart involvement,which belongs to the categories of palpitations,chest obstruction TCM symptoms.According to the characteristics of the pathogenesis and etiology,deficiency syndrome accompanies the whole process of diabetic cardiomyopathy.Therefore,from the overall direction of the deficiency and excess treatment based on syndrome differentiation,it has good significance for guiding the clinical diagnosis and treatment of diabetic cardiomyopathy.This paper,from the perspective of deficiency and excess,discusses the treatment of diabetic cardiomyopathy to prevent and delay diabetic cardiomyopathy.

关 键 词：糖尿病心肌病 消渴症 病机 

分 类 号：R587.1[医药卫生—内分泌]