以“脾胃转枢”理论辨治2型糖尿病血糖波动

Treatment of Glucose Fluctuation of Type 2 Diabetes Mellitus Based on Transfer Function of Spleen and Stomach Qi

减少血糖波动是2型糖尿病患者血糖控制的重点与难点。脾胃为中土之脏,脾胃气机升降是维持机体五脏气血生化的枢纽。“脾胃转枢”是从气机升降运动角度强调脾胃之气斡旋中焦,协调脏腑气机、营卫循行、气化转枢,对周身气机运行起着重要的中轴转枢功能。脾胰受损、脾不散精、五脏气机升降失调是血糖波动的基本病机。在糖尿病血糖波动治疗中,临床上应秉承重在助脾散精,兼顾五脏,协调气机升降、平衡气血阴阳的治疗理念,使水谷精微的转输与利用恢复正常,则糖浊可化、并发症得以缓解,彰显中医维持血糖稳态的科学内涵。

Reducing blood glucose fluctuation is the key and difficult point of blood glucose control in patients with type 2 diabetes.The spleen and stomach are the organs of the middle Jiao.The Qi movement of the spleen and stomach is the key to maintain the Qi and blood biochemistry of the five Zang-organs of the body.“The transfer function of spleen and stomach Qi”emphasizes that the Qi of the spleen and stomach mediates the middle Jiao,coordinates the Qi of Zang-organs,the circulation of Ying and Wei and the functional activity of Qi,and plays an important role in the operation of Qi in the whole body.The basic pathogenesis of blood glucose fluctuation is the damage to spleen and pancreas,spleen not dispersing essence,five viscera Qi disorder.In the treatment,we should adhere to the treatment concept of supporting the spleen and dispersing essence,giving consideration to the five organs,coordinating the transfer function of Qi,balancing Qi,blood,Yin and Yang,so as to make the transfer and utilization of essence return to normal,so that the turbid glucose can be transformed,the complications can be alleviated,and the scientific connotation of maintaining blood glucose homeostasis in traditional Chinese medicine can be demonstrated.