摘要
以糖尿病病理改变为基础,以症状体征为线索,基于《黄帝内经》中脾瘅、消瘅论述,结合临床实际,系统阐述糖尿病的类型、发展及转归等内容,并构建基于糖尿病分类(根据胖瘦分为脾瘅、消瘅2类)、分期(根据自然演变过程可以分为郁、热、虚、损4期)、分证思想体系指导下的糖尿病防治临床实践。在糖尿病辨证前首先应分类,分类清晰,此后的分期分证方能有条不紊;次而分期,以病理改变为基础,以症状体征为线索,注重找寻不同时期的核心病机,判定疾病处于何期;然后进行分证,即辨明疾病所处的病位、病性,把握寒热虚实,有针对性地解决突出矛盾。分类、分期、分证思想综合考量疾病共性及患者个性,可为现代慢性病中医理论构建提供启示。
Taking diabetes meilitus pathological changes as the-basis, taking symptoms and signs as the clue, based on the discussion of spleen fever （脾瘅） and consumptive fever （消瘅） in Inner Canon of Yellow Emperor （黄帝内经）, combined with clinical practice, the authors expound the types, development and outcomes of diabetes melli- tus and construct the clinical practice of preventing and treating diabetes mellitus based on the guidance of diabetes mellitus theory system by types （spleen fever and consumptive fever according to fat or thin body）, by stages （stagnation- heat-deficiency-damage stages according to natural evolutional process） and by syndromes. Before diabetes mellitus syndrome differentiation, firstly classification should be conducted. Clear classification makes stages and syndromes methodically determined. Secondly, the stages should be determined, which should take pathological changes as the basis, symptoms and signs as the clue. It is emphasized that finding the core pathogenesis at different stages. Thirdly, the syndromes should be determined, which means to know the location and character （cold, heat, deficiency and excess） of the disease and solve the outstanding contradiction in a targeted way. The theory of by types, by stages and by syndromes could comprehensively consider the disease similarity and patient personality, which may provide enlightenment for Chinese medicine theory construction in modern chronic diseases.
出处
《中医杂志》
CSCD
北大核心
2017年第24期2091-2094,共4页
Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81430097)
关键词
慢性病
糖尿病
治疗模式
分类、分期、分证思想
chronic disease
diabetes mellitus
treatment mode
type, stage and syndrome theory
