魏爱生从“补不足,损有余”论治2型糖尿病经验介绍  

Introduction of WEI Aisheng's Experience in Treating Type 2 Diabetes Mellitus by"Supplementing Insufficiency and Draining Excess"

作　　者：吴俊锐 张彩霞[1] 刘晓霞[2] 何东盈 魏爱生(指导)[1,2] WU Junrui;ZHANG Caixia;LIU Xiaoxia;HE Dongying;WEI Aisheng(The Eighth Clinical Medical School of Guangzhou University of Chinese Medicine,Foshan Guangdong 528000,China;Department of Endocrinology,Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong 528000,China)

机构地区：[1]广州中医药大学第八临床医学院,广东佛山528000 [2]佛山市中医院内分泌科,广东佛山528000

出　　处：《新中医》2025年第4期199-204,共6页New Chinese Medicine

基　　金：广东省中医药局省级名中医传承工作室建设项目(粤中医办涵[2023]10号)。

摘　　要：总结介绍魏爱生教授以“补不足,损有余”为原则论治2型糖尿病的临床经验。魏爱生教授提出,以“补不足,损有余”为原则,以水液代谢情况作为2型糖尿病辨证要点。治疗上,辨清病理产物之有余及偏重,损痰湿、瘀血、郁热之有余,以痰湿为要;注重祛邪,邪之出路;后期以肺脾二脏为主,重在补气、阴之不足。临证将2型糖尿病分为胃强脾弱湿浊证、气滞血瘀证、肝郁化火证、肺脾气虚湿滞证、气阴两虚证五种证型。以水液有余之胃强脾弱湿浊证为常见证型,以三黄茵陈五苓散加减治疗,水液代谢异常之气滞、肝郁、血瘀为辅佐,常用丹栀逍遥散、血府逐瘀汤加减;水液不足常呈气阴两虚证,选用降糖一方补气滋阴;善后多用参苓白术散加减,同时喜用药食同源之药,甘淡和胃。This paper introduces WEI Aisheng's experience in treating type 2 diabetes mellitus by"supplementing insufficiency and draining excess".Professor WEI Aisheng proposes that the principle of"supplementing insufficiency and draining excess"is taken as the key point of syndrome differentiation of type 2 diabetes mellitus.In the treatment,the excess and bias of the pathological products should be differentiated,and then the excess of phlegm-damp,static blood and constraint heat should be drained,especially phlegm-damp.Attention is paid to dispelling pathogen and making way for pathogen out.In the later stage,the lung and spleen are mainly valued,and the focus is on supplementing insufficiency of qi and yin.In clinical practice,type 2 diabetes mellitus can be divided into five types:syndrome of strong stomach,weak spleen and damp-turbidity,syndrome of qi stagnation and blood stasis,syndrome of liver constraint transforming into fire,syndrome of lung-spleen qi deficiency and damp stagnation,and syndrome of deficiency of qi and yin.The main syndrome is strong stomach,weak spleen and damp-turbidity caused by excessive water and fluids,and it is treated with modified Sanhuang Yinchen Wuling Powder.The secondary syndrome is qi stagnation,liver constraint and blood stasis caused by abnormal metabolism of water and fluids,and it is often treated with modified Danzhi Xiaoyao Powder and Xuefu Zhuyu Decoction.For patients with insufficiency of water and fluids,they are mainly with syndrome of deficiency of qi and yin,and the treatment is to use Jiangtang No.1 Prescription to supplement qi and nourish yin.In the late stage,modified Shenling Baizhu Powder is often used,and homologous Chinese medicinals are also often applied,using sweet and bland medicinals to harmonize the stomach.

关 键 词：2型糖尿病 补不足 损有余 痰湿 水液代谢 药食同源 魏爱生 

分 类 号：R249[医药卫生—中医临床基础] R587.1[医药卫生—中医学]