基于伏邪理论探讨糖尿病前期的中医防治

Discussion on Prevention and Treatment of Traditional Chinese Medicine for Prediabetes Based on the Theory of Latent Pathogen

糖尿病前期属于糖尿病的“未发”阶段,此阶段虽已发生胰岛素抵抗、胰岛β细胞功能缺陷等病理生理改变,其病变发生隐匿,致病过程漫长,符合中医“伏邪”致病特征。基于伏邪理论,本病责之脾气亏虚,以痰瘀伏邪为主的伏邪藏于体内,日渐积累,损伤散膏与三焦,气机升降失调,终致脾不散精。伏邪久羁,脾运受损导致消渴发生是本病的重要转归。在中医“治未病”思想指导下,对糖尿病前期进行干预有利于延缓糖尿病的发生发展。本病的治疗应在生活调摄的基础上,以健脾固本、及早祛除伏邪为原则,为本病提供中医防治的思路与方法。

Prediabetes,the“non onset”stage of diabetes,in which invisible pathophysiological changes such as insulin resistance,isletβ-cell dysfunction already exist,has long-term pathogenic impact on the body with dormant,according with the characteristics of“latent pathogen”in Traditional Chinese Medicine(TCM).Based on the theory of latent pathogen,prediabetes takes its rise from spleen Qi deficiency,accompanied by hidden latent pathogens composed mainly of phlegm and blood stasis accumulating in vivo,so that San Gao and triple energizer are damaged and Qi movement is disordered,eventually the spleen fails to disperse essence.The important outcome of this disease is the occurrence of diabetes caused by the persistent internal latent pathogens and dysfunction of spleen governing transportation and transfomation.Under the guidance of“preventive treatment of disease”theory in TCM,the intervention on prediabetes contributes to delay the occurrence and development of diabetes.The principle of invigorating spleen and consolidating body resistance and eliminating latent pathogens as soon as possible,which is on the foundation of life style adjustment,provides the ideas and methods of TCM for the disease’s prevention and treatment.