从“五脏传变”辨治糖尿病并发症  

Syndrome Differentiation and Treatment of Diabetes Complications from the Perspective of"Disease Transmitting and Changing Among Five Zang"

作　　者：郑爽 黄珂[1] 张蕊[1] 邹本良[1] ZHENG Shuang;HUANG Ke;ZHANG Rui;ZOU Benliang(Xiyuan Hospital Affiliated to China Academy of Chinese Medical Sciences,Beijing China 100091)

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《中医学报》2024年第9期1836-1840,共5页Acta Chinese Medicine

基　　金：北京中医药薪火传承“新3+3”工程首批培育类“三名”传承工作室项目{京中医科字〔2023〕126号};中国中医科学院“育苗基金培育专项”资助项目(ZZ11-070)。

摘　　要：糖尿病胃轻瘫多因肝木郁滞乘克脾土所致,治疗时强调疏肝与健脾并重,辅以祛瘀化浊之法;糖尿病肾病病机在于脾虚湿盛,累及肾脏,导致肾元受损,治疗时倡导健脾与补肾相结合,同时注重温阳以助水湿运化;糖尿病性勃起功能障碍多由肾阴亏虚难制心火引起,治疗可采用交通心肾之法,实现清补并行,以平衡心肾之阴阳;糖尿病心脏病发病机理涉及心火过旺,灼伤肺金,治疗时主张清热滋阴合用,佐以化痰散瘀之法;糖尿病瘙痒症多因肺热炽盛耗伤肝阴所致,治疗时应宁肺平肝,同时注重养血祛风。Diabetic gastroparesis is mostly caused by the stagnation of the Liver Qi injuring the Spleen,and in the treatment both Liver Qi soothing and Spleen strengthening should be emphasized,supplemented by the method of removing stasis and Turbidity.The pathogenesis of diabetic nephropathy lies in Spleen deficiency and severe Dampness,which affects the kidneys and leads to damage to the Kidney Yuan.During the treatment,it is advocated that the combination of strengthening the Spleen and tonifying the Kidney,and at the same time warming the Yang to help the transportation of Water and Dampness should be paid attention to.Diabetic erectile dysfunction is mostly caused by Kidney Yin deficiency induced difficulty in harmonizing Heart Fire,and the treatment should be communicating the Heart and Kidney to achieve the parallel effect of clearing and replenishment,so as to balance the Yin and Yang of the Heart and Kidney.The pathogenesis of diabetic heart disease involves excessive Heart Fire burning the Lung.During the treatment,it is advocated to clear away Heat and nourish Yin,accompanied by the method of dissolving Phlegm and dissipating stasis.Diabetic pruritus is mostly caused by the hot and blazing Lung induced Liver Yin depleting,and in treatment the Lung and Liver should be calmed,at the same time nourishing blood and dispelling Wind being paid attention to.

关 键 词：糖尿病并发症 “肝病实脾” “五脏传变” 治未病 

分 类 号：R259.872[医药卫生—中西医结合]