基于“热气怫郁,玄府闭密”病机辨治糖尿病性骨质疏松症的经验  

Differentiation and treatment of diabetic osteoporosis based on the pathomechanism of"heat qi depression and obstruction of Xuanfu"

作　　者：徐明君 魏军平[2] XU Mingjun;WEI Junping(Beijing University of Chinese Medicine,Beijing 100029,China;Office of Academic Research,Guang'anmen Hospital,China Academy of Chinese medical Sciences,Beijing 100053)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院广安门医院科研处,北京100053

出　　处：《北京中医药》2025年第2期214-218,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A01617);中国中医科学院广安门医院科研项目(2023012)。

摘　　要：玄府具有通利的特性。糖尿病性骨质疏松症以糖尿病为基础发展而来,“热气怫郁”是糖尿病的基础病机,“玄府闭密”是糖尿病进展为DOP的核心病机。治疗DOP应以开通玄府为治法总纲,去除玄府郁闭之因,“复其开合,贵于通利”,使脉络得通,糖毒得祛,恢复精气血津液通畅。糖尿病病久脏腑失养,玄府亏虚,故疾病后期应当注重充养玄府,用补虚之法濡养精气血津液,从而强健骨骼。临床可用风药辛散宣通开玄、虫类药破血祛瘀开玄、补虚药健脾益肾开玄。Xuanfu has the characteristic of being convenient.Diabetes osteoporosis is based on diabetes."heat qi depression"is the basic pathogenesis of diabetes,and"obstruction of Xuanfu"is the core pathogenesis of diabetes evolving into DOP.The treatment of DOP should be based on the general principle of opening up the Xuanfu,removing the cause of stagnation in the Xuanfu,and restoring its opening and closing is more important than promoting diuresis so as to unblock the meridians,eliminate sugar toxins,and restore the smoothness of essence,qi,blood,and body fluids.In diabetes,the viscera lose nourishment for a long time,and the Xuanfu is deficient.Therefore,in the later stage of the disease,attention should be paid to nourishing the Xuanfu,nourishing the essence,qi,blood,and body fluid with the method of tonifying deficiency,so as to strengthen the bones.When treating diseases clinically,one can use wind medicine,Xinsan,Xuantong,Kaixuan,and insect medicine to break blood and remove blood stasis,as well as tonifying deficiency medicine to invigorate the spleen and benefit the kidneys.

关 键 词：糖尿病性骨质疏松症 玄府 风药 虫类药 

分 类 号：R259[医药卫生—中西医结合]