陈霞波基于“治未病”理论防治糖尿病经验  

Chen Xiabo's Experience of Preventing and Treating Diabetes Based on the Theory of"Preventive Treatment"

作　　者：李梦婷[1] 张业[2] 金汀龙 宋一帆 唐艳 陈霞波[2] LI Mengting;ZHANG Ye;JIN Tinglong;SONG Yifan;TANG Yan;CHEN Xiabo(Zhejiang Chinese Medical University,Hangzhou,Zhejiang,China,310053;Ningbo Municipal Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Ningbo,Zhejiang,China,315010)

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]浙江中医药大学附属宁波市中医院,浙江宁波315010

出　　处：《河南中医》2024年第8期1194-1198,共5页Henan Traditional Chinese Medicine

基　　金：浙江省名老中医专家传承工作室建设计划陈霞波名老中医专家传承工作室项目(GZS2017017)。

摘　　要：陈霞波教授将糖尿病分为原始期、前驱期、消渴期、逆归期,将未病先防、已病防变、瘥后防复的“治未病”理论同糖尿病四期辨证有机结合,并灵活运用于糖尿病的预防和治疗中,形成“防-治-养”的健康管理模式,遵循整体观,从全方位、全要素、全流程阶段论治。原始期的基本病机为真气不足,主要病在脾、肾两脏,脾虚者常以六君子汤健脾助运,肾精不足者以左归丸、右归丸补肾益精,对于肝郁引起脾虚者常以四逆散合异功散加减疏肝健脾。前驱期,病位在肺、脾,往往虚中夹实,常用参苓白术散、升清降浊汤、参麦四君汤合芪归玉精汤、竹叶石膏汤、玉女煎或人参白虎汤等治疗。根据消渴期气化失常、气郁燥热的基本病机,常用白虎汤、升清降浊汤、舒情宁心汤、肾气丸等治疗。逆归期,病位涉及心、肺、肝、脾、肾等诸多脏腑,陈教授常采用五体辨证同脏腑辨证相结合的方法来诊断,治疗上主张调整阴阳,以调复气机,化痰散瘀,养血活络,调和营卫为主要治法。陈教授认为,对病未发者给予饮食、运动的宣教和指导,中药调体改善偏颇体质,预防疾病发生;对已发消渴者,采取中西医结合治疗,尽可能减少西药用量,减轻药物不良反应;对于逆归期患者,通过五脏和五体辨证治疗,缓解临床症状,提高生活质量,以带病延年;对血糖控制稳定的患者予膏方调理,扶正与祛邪兼顾,以增强体质,调节脏腑机能。Professor Chen Xiabo divides diabetes into the initial stage,prodromal stage,wasting thirst stage and retrogression stage.She organically combines the theory of"preventive treatment",including treating disease before its onset,controlling development of existing disease,and prevention of recurrence after cure,with the four stage syndrome dfferentiation of diabetes,and flexibly applies it to the prevention and treatment of diabetes to form a health management model of"prevention-treatment-maintenance".She fllows the holistic view,and treat it from all aspects,allelements,and all process stages.The basic pathogenesis of the initial stage is deficiency of genuine qi,mainly affecting the spleen and kidney.For those with spleen deficiency,Six Gentlemen Decoction is often used to invigorate the spleen and promote circulation.For those with kidney essence deficiency,Yin-restoring Pill and Yang-restoring Pill are used to nourish the kidney and replenish essence.For those with liver depression causing spleen deficiency,Frigid Extremities Powder combined with Special Achievement Powder are often modified to soothe the liver and invigorate the spleen.In the prodromal stage,the disease locates in the lung and spleen,often with deficiency mixed with consolidation.Treatment options include Ginseng and Poria and White Atractylodes Powder,Decoction for Raising Lucid Yang and Reducing Turbidity,Ginseng and Radix Ophiopogonis Four Gentlemen Decoction combined with Astragalus and Chinese Angelica Drink and Decoction,Lophatherum and Gypsum Decoction,Jade Lady Decoction,or Ginseng White Tiger Decoction,etc.According to the basic pathogenesis of qi disorders,qi stagnation,and dryness during the wasting thirst stage,commonly used treatments include White Tiger Decoction,Decoction for Raising Lucid Yang and Reducing Turbidity,Emotion-Expressing and Heart-Calming Decoction,and Kidney Qi Pill,etc.At retrogression stage,the disease affects many organs such as the heart,lung,liver,spleen,and kidney,etc.Professor Chen often uses a combinatio

关 键 词：糖尿病 “治未病” “防-治-养” 陈霞波 

分 类 号：R259.871[医药卫生—中西医结合]