基于阴火理论探讨糖尿病相关性肌少症证治  

Discussion on the syndrome differentiation and treatment of diabetes-related sarcopenia based on Yin-fire theory

作　　者：赵馨 崔云竹[2] ZHAO Xin

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院,山东济南250011

出　　处：《中医临床研究》2024年第7期24-28,共5页Clinical Journal Of Chinese Medicine

摘　　要：金元四大医家之一李杲(号东垣)提出了“脾胃气伤,升发失常;元气不充,阴火内盛”为核心的阴火理论,与糖尿病相关性肌少症的发病机制较为契合。气虚与“阴火”关系密切,脾胃气虚在“阴火”的形成中发挥重要作用。糖尿病相关性肌少症是指与血糖升高相关的以骨骼肌质量和肌肉力量或躯体功能下降为特征的糖尿病并发症,与中医证候中的“阴火”表现相似。文章以“阴火”理论为基础,从中医学角度分析糖尿病相关性肌少症的发病机制和辨证治法,认为元气虚损是糖尿病相关性肌少症发生的基础,气火失调是其发展的病因,探讨阴火与糖尿病相关性肌少症发病机制之间的关系,并运用阴火理论防治糖尿病相关性肌少症。糖尿病相关性肌少症属于中医学“消渴并发痿证”的范畴,元气虚衰,阴火内炽是其内在发病机制。糖尿病相关性肌少症因消渴病久累及骨肉筋脉所发,因机证治与李杲的阴火理论相符。从中医整体观念出发,治疗以补脾胃、升清阳、泻阴火为主,甘温除热,升阳泻火贯穿该病治疗全过程,旨在进一步完善糖尿病相关性肌少症的中医理论,从而为糖尿病相关性肌少症临床诊断和治疗提供理论依据。LI Gao,one of the Four Great Physicians of the Jin-Yuan Dynasty,put forward the theory of Yin-fire(阴火),which centers on the fact that when the spleen and stomach Qi(气)are injured,there is an abnormality of ascension and despondency;when the vital Qi is not full,there is an exuberance of Yin-fire within the body,which is more compatible with the pathogenesis of diabetes-related sarcopenia.Qi deficiency is closely related to Yin-fire,and the deficiency of spleen and stomach Qi plays an important roleL in the formation of Yin-fire.Diabetes-related sarcopenia is a diabetic complication associated with elevated blood glucose and characterized by a decrease in skeletal muscle mass and muscle strength or somatic function,which is similar to the manifestation of Yin-fire in TCM.Based on the theory of Yin-fire,we analyze the pathogenesis and treatment of diabetes-related sarcopenia from the perspective of TCM,and conclude that the deficiency of vital energy is the basis for the occurrence of diabetes-related sarcopenia,and the imbalance of Qi and fire is the etiology for the development of diabetes-related sarcopenia.The relationship between Yin-fire and the pathogenesis of diabetes-related sarcopenia is discussed,and the theory of Yin-fire is applied to prevent and treat diabetes-related sarcopenia.Diabetes-related sarcopenia belongs to the category of Xiaoke(消渴)associated with Wei syndrome(痿证)in TCM,and its intrinsic pathogenesis is the deficiency of vital energy and the internal blazing of Yin-fire.Diabetes-related sarcopenia is caused by the prolonged involvement of bone,flesh,muscle and veins due to Xiaoke,which is in line with LI Gao’s theory of Yin-fire.From the overall concept of TCM,the treatment is based on tonifying the spleen and stomach,elevating the clear Yang(阳),and diarrhea of Yin-fire,the methods of clearing heat with sweet-warm medicines,and elevating the Yang and purging fire run through the whole process of the treatment of this disease,which is aimed at further improving the TCM theo

关 键 词：阴火 糖尿病相关性肌少症 消渴 痿证 证治特点 

分 类 号：R25[医药卫生—中医内科学]