摘要
现今初发2型糖尿病患者以形体肥胖者居多,以胖大舌、厚腻苔多见,如《素问·奇病论》中对“脾瘅”的描述。在血糖极高的患者中,常可见到舌红少苔“阴虚火旺”之象,但这并不能代表2型糖尿病发生发展的全过程。结合临床及古今医家的经验,笔者认为“脾不化气,蕴毒生热”是2型糖尿病发生发展的基本病机。多食肥甘、久坐少动、情绪异常是现代2型糖尿病的主要病因,助脾运化是该病基本治法,以兰草汤为代表的芳香化湿类药物具有辛开苦降之功,不仅可以芳化浊毒、条达气机,还可以助脾运化,能够从根本上改善血糖代谢异常,值得我们实践探索。
At present,patients experiencing the first onset of type 2 diabetes are mostly obese and accompanied by a fat tongue and thick greasy coating on the tongue,which is similar to the description of"spleen heat disease"in Plain Questions:Treatise on Peculiar Diseases."Yin deficiency with excessive fire"image,which is characterized by a red tongue and less coating on the tongue,is common in diabetic patients with extremely high blood glucose levels,but it does not represent the whole pathological process of type 2 diabetes.Based on clinical observations and the experiences of ancient and modern physicians,the authors thought that"spleen Qi dysfunction leading to toxin accumulation and heat generation"is the basic pathogenesis of type 2 diabetes.Eating more sweet food and greasy food,prolonged stting and less movement,and emotional disturbances are the main causes of modern type 2 diabetes.Promoting spleen transportation and transformation is the basic treatment principle of type 2 diabetes.Aromatic dampness-resolving herbs,represented by"Eupatorium fortunei Decoction",possess the functions of pungent and bitter drugs for body regulation.These herbs not only aromatize the turbid toxin and regulate Qi movement but also strengthen the spleen transportation and transformation function,fundamentally improving the abnormal glucose metabolism.This approach is worth further clinical exploration.
作者
李治
王辰宇
刘心悦
李楠
叶丽芳
LI Zhi;WANG Chenyu;LIU Xinyue;LI Nan;YE Lifang(Nanjing University of Chinese Medicine,Nanjing 210029,China;Department of Endocrinology,The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)
出处
《基层中医药》
2025年第5期40-46,共7页
Basic Traditional Chinese Medicine
基金
国家自然科学基金青年科学基金项目(82104751)
江苏省中医药科技发展计划项目(MS2021010)
2024年江苏省研究生实践创新计划项目(SJCX24_0981)。
关键词
2型糖尿病
脾不化气
蕴毒生热
痰瘀互结
辛开苦降
type 2 diabetes
spleen Qi dysfunction
toxin accumulation and heat generation
turbid phlegm and blood stasis
pungent and bitter drug for body regulation
