基于“小肠气化失司-泌别清浊障碍”探析糖尿病血糖波动机理

Analysis on Mechanism of Glucose Variability in Diabetes Mellitus based on“Qi-dysfunction-no Ability to Separate Clear and Turbid”theory of Small Intestinal

血糖波动较高血糖危害更甚,是当前临床的治疗难点及研究热点。本文从小肠功能入手,厘清小肠与脾在精微物质生、长、化、收、藏中的具体作用,认为血糖波动应主要责之小肠失于“气化-泌别清浊”,使精微失源、失清、失运,其核心病机可由小肠气化失司、清浊不分、精失正化以概之。这与现代医学“肠道菌群失调可多途径、多角度影响血糖波动”的观点高度切合。故着眼于“小肠气化失司-泌别清浊障碍”的基础病机,以肠道菌群为重要靶点,重视“益肠运肠”的研究方向有望拓展中医药防治糖尿病血糖波动的新视野。

Glucose variability is more harmful than hyperglycemia,and is a current clinical treatment difficult and research hotspot.This paper addresses the function of the small intestine and identifies the specific roles played by the small intestine and spleen in the generation,growth,transformation,collection,and storage of subtle substances.The failure of the small intestine to perform its function of“Qi activity-separate clear and turbid”is primarily responsible for glucose variability,resulting in a loss of purity,movement,and source of nutrient substances.The key pathogenesis is the Qi-dysfunction of the small intestine,which is unable to separate clear and turbid and normalize essence.This is consistent with modern medicine's view that“dysbacteriosis of the intestinal flora can affect glucose variability in multiple ways and from multiple angles.”Thus,by targeting the basic pathogenesis of“Qi-dysfunction-no ability to separate clear and turbid”of the small intestine and focusing on the intestinal flora,we can expand the scope of traditional Chinese medicine in the prevention and treatment of diabetes mellitus with glucose variability.This paper concludes that research in the direction of“benefiting and transporting small intestine”is expected to broaden the horizons of traditional Chinese medicine in this regard.