从“病证结合,通调五脏”论治糖尿病便秘  

Treatment of Diabetic Constipation Based on Theory of"Combining Disease and Symptoms and Regulating Five Zang"

作　　者：高艺玮 张宁[1] GAO Yiwei;ZHANG Ning(Wangjing Hospital Affiliated to China Academy of Chinese Medical Sciences,Beijing China 100102)

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《中医学报》2024年第11期2321-2325,共5页Acta Chinese Medicine

基　　金：中国中医科学院科技创新工程项目(CI2021A01609)。

摘　　要：便秘是糖尿病患者临床常见的症状。排便情况的改善,对患者的血糖水平、生活质量意义重大。糖尿病并发症众多,五脏六腑均可被累及,脾系症状者,以胃肠热结为主;肾系症状者,以肾阴亏虚为主;肺系症状者,以燥热伤肺为主;肝系症状者,以肝失疏泄为主;心系症状者,以五脏失衡为主。临证不可但见便秘而只知泻下通腑,需病证结合,通调五脏,方能邪去而不伤正。临证治疗本病,既考虑糖尿病及其并发症本身的特质,又结合患者的个体化复合症状,判断五脏功能失衡的偏重,形成了“病证结合,通调五脏”的学术思想。临床遣方用药总以清热为要,主要分为“滋阴、凉血、清肺”3个方面,每每辅以疏肝理气,兼补肺脾之品。同时注重调理使患者最为焦虑不安的症状,劝导患者于生活中调摄情志,以达平衡五脏之功。Constipation is a common clinical symptom in diabetic patients.The improvement of bowel movement is of great significance to the blood glucose level and quality of life of patients.There are many complications of diabetes,all Five Zang and Six Fu can be involved.Patients with Spleen symptoms mainly suffer from gastrointestinal Heat stagnation;Patients with renal symptoms mainly suffer from Kidney Yin deficient;Patients with pulmonary symptoms mainly suffer from Heat and inflammation disturbing Lung;Patients with hepatic symptoms mainly suffer from Liver Qi dispersing dysfunction;Those with Heart symptoms mainly suffer from imbalanced Five Zang relationship.In clinical practice,it is not always necessary to dredge Fu in treatment of constipation,while it is necessary to combine the symptoms and regulate the Five Zang so that the evil factors can be removed without harming the Zheng Qi.In professor Zhang Ning′s clinical treatment of this disease,not only the characteristics of diabetes and its complications itself are considered,but also the individualized compound symptoms of patients are used to judge the imbalance of the Five Zang,forming an academic idea of"combining disease and symptoms and regulating Five Zang".The clinical prescription mainly focuses on clearing Heat,which is mainly divided into three aspects:"nourishing Yin,cooling blood and clearing Lung Heat".At the same time,the symptoms that make patients most anxious and uneasy are paid great attention,and patients are persuaded to adjust their emotions in life,to achieve the balance of the Five Zang.

关 键 词：糖尿病便秘 “病证结合 通调五脏” 滋阴清热法 凉血清热法 清泻肺热法 

分 类 号：R256.35[医药卫生—中医内科学]