基于“燥热怫郁”理论探讨糖尿病胃肠病的防治  

A study of the prevention and treatment of diabetic gastrointestinal disease based on the theory of“dryness-heat and stagnation”

作　　者：李欣蕊 杨宇峰[1] LI Xinrui

机构地区：[1]辽宁中医药大学,辽宁沈阳110847

出　　处：《中医临床研究》2024年第34期81-85,共5页Clinical Journal Of Chinese Medicine

基　　金：辽宁省中央引导地方科技发展专项(No.2019JH6/10200009);2023年辽宁省教育厅高校基本科研项目(No.JYTZD2023197)。

摘　　要：糖尿病胃肠病是糖尿病常见的慢性消化系统并发症,具有发病过程隐匿与结局严重不良的致病特征,会影响从食管至直肠的消化道的多个部分,导致恶心、呕吐等症状,直接影响患者的日常饮食、生活及生存质量,危害严重。现代医学目前概括了自主神经病变、高血糖、消化道激素分泌异常、胃肠道平滑肌病变、微血管病变、代谢紊乱、继发感染、精神心理因素等发病因素。“燥热怫郁”理论源远流长,是刘完素在临床实践中探索出的以泻实补虚、以平为期为主要治疗原则的理论基础,在中医消渴病诊疗探索中有重要作用。本研究对糖尿病胃肠病的中医认识和“燥热怫郁”理论渊源进行探讨,论述糖尿病胃肠病的病机演变过程,并对中医药治疗糖尿病胃肠病的相关文献进行总结分析,以脾胃为切入点,从“燥热怫郁”理论角度入手,探讨糖尿病胃肠病与“燥热怫郁”之间的关系,并阐述“燥热怫郁”理论在糖尿病胃肠病防治中的作用。饮食不节、脾胃亏虚是导致燥热内生、腠理怫郁,从而引起糖尿病胃肠病的关键病机。因此,基于燥热怫郁理论,中医药在糖尿病胃肠病临床治疗中能够更有效地发挥其多途径、多靶点、整体调控的优势,助益糖尿病胃肠病临床治疗,促进糖尿病胃肠病的深入研究,对中医药临床防治糖尿病胃肠病有重要意义。Diabetic gastrointestinal disease is a common chronic digestive system complication of diabetes,which is characterized by hidden pathogenesis and serious adverse outcome.The disease can affect many parts of the digestive tract from esophagus to rectum,causing nausea,vomiting and other symptoms in patients,directly affecting the daily diet,life,and quality of life of patients,with serious harm.Modern medicine has summarized the pathogenesis of autonomic neuropathy,hyperglycemia,gastrointestinal hormone secretion abnormality,gastrointestinal smooth muscle disease,microvascular disease,metabolic disorders,secondary infection,psychopsychological factors and so on.The theory of“dryness-heat and stagnation”has a long history.It is the theoretical basis for LIU Wansu’s clinical practice to explore the principle of expelling excess and replenishing deficiency and harmonizing Qi(气)and blood of the patient,which plays an important role in the exploration of TCM’s diabetes diagnosis and treatment.This paper introduced the understanding of diabetic gastrointestinal disease and the theoretical origin of dryness-heat and stagnation in TCM,discussed the pathogenesis and evolution of diabetic gastrointestinal disease,and summarized and analyzed the relevant literature on the treatment of diabetic gastrointestinal disease in TCM.Taking the spleen and stomach as the starting point,this paper discussed the relationship between diabetic gastrointestinal disease and dryness-heat and stagnation from the perspective of“dryness-heat and stagnation”theory.The effect of“dryness-heat and stagnation”theory on the prevention and treatment of diabetic gastrointestinal disease was expounded.Improper diet and deficiency of spleen and stomach are the key pathogenesis leading to endogenous dryness and heat,and depression of the ciliary tract,which lead to diabetic gastrointestinal disease.Therefore,under the guidance of the hot and dry theory,TCM can more effectively exert its therapeutic advantages of multi-channel,multi-target

关 键 词：燥热怫郁 糖尿病胃肠病 脾胃 三焦 腠理 

分 类 号：R587.1[医药卫生—内分泌]