从“虚,郁,痰,瘀”探讨肥胖型糖尿病前期的辨治  

To Discuss the Pathogenesis and Treatment of Obeseprediabetes from“Deficiency,Depression,Phlegm and Stasis”

作　　者：姜金池 王莉[1] JIANG Jinchi;WANG Li(The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning Shenyang 110031,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110031

出　　处：《中医药临床杂志》2025年第2期210-214,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：辽宁省应用基础研究计划项目(2022JH2/101300108)。

摘　　要：糖尿病前期是一种处于健康状态和2型糖尿病患病状态之间的一种慢性代谢失调状态。其患病率在逐年上升,且患病人群中每年大致有5%~10%发展成为2型糖尿病。目前,大量的资料和临床经验显示,肥胖会大大提高糖尿病前期的患病风险,防治肥胖型糖尿病前期刻不容缓。中医学认为肥胖型糖尿病前期的病机以脾虚为本,气郁痰湿血瘀为标。肥胖型糖尿病前期隶属于中医脾瘅的范畴,其病因病机为中满内热、脾气失司、情志失调、痰湿内生、脉络瘀损。根据前人总结和现代医家对肥胖型糖尿病前期的认识,从“虚,郁,痰,郁”四个方面探讨其病因病机,即脾气亏虚,肝郁内热,痰湿内生,瘀血内停为肥胖型糖尿病前期的致病因素,治法包括益气健脾化痰,疏肝清热活血。Prediabetes is a chronic metabolic disorder between a healthy state and the state of type 2 diabetes.Its prevalence is increasing year by year,and about 5%to 10%of the patients develop into type 2 diabetes each year.At present,a large amount of data and clinical experience show that obesity greatly increases the risk of prediabetes,and prevention and treatment of obese prediabetes are urgent.Traditional Chinese medicine believes that the pathogenesis of obese prediabetes is spleen deficiency as the root,and Qi stagnation,phlegm dampness and blood stasis as the symptoms.Obese prediabetes belongs to the category of spleen deficiency in traditional Chinese medicine,and its etiology and pathogenesis are fullness and internal heat,spleen dysfunction,emotional disorder,endogenous phlegm dampness,and blood stasis in the veins.According to the summary of predecessors and the understanding of modern doctors on prediabetes of obesity type,the etiology and pathogenesis of prediabetes of obesity type are discussed from four aspects:“deficiency,depression,phlegm,depression”,namely spleen deficiency,liver depression and internal heat,phlegm and dampness,and blood stasis are the pathogenic factors of prediabetes of obesity type.The treatment methods include invigorating Qi,strengthening spleen and resolving phlegm,soothing liver,clearing heat and activating blood circulation.

关 键 词：肥胖型糖尿病前期 脾瘅 病因病机 中医药疗法 

分 类 号：R255.4[医药卫生—中医内科学]