基于滞-热-损探讨糖尿病前期的治疗

Discussion on the Treatment of Pre-diabetes Based on Stagnation-heat-damage

[目的]基于脾瘅的发病病因,从“滞-热-损”角度探析糖尿病前期的临床治疗。[方法]围绕脾瘅形成的病因,在查阅诸多古籍文献和现代研究的基础上,探究“滞-热-损”在糖尿病前期发生发展及诊治中的重要意义,并附医案一则以证其效。[结果]“滞-热-损”是糖尿病前期形成的重要病理基础,其中饮食不节、脾胃壅滞为始动因素,壮火食气、滞热伤脾为中心环节,过用为劳、脾虚受损为最终进展,且滞-热-损与胰岛素抵抗的形成关系密切。因机立法制方,将消滞、清热、防损作为糖尿病前期的主要治法,参古方玉液汤创脾瘅降糖方,用于糖尿病前期的治疗可获良效。所附临床典型验案,西医诊断属糖尿病前期,中医四诊合参辨病为脾瘅,辨证为脾胃壅滞、滞热伤脾证,治以消滞清热、健脾益气为法,方以脾瘅降糖方加减,用之效可。[结论]滞-热-损是糖尿病前期形成的重要病理因素,以消滞、清热、防损为法组方的脾瘅降糖方临床验之有效。

[Objective] Based on the etiology of Pidan, the clinical treatment of pre-diabetes was analyzed from the angle of stagnationheat-damage. [Methods] Focusing on the causes of Pidan, on the basis of consulting many ancient books and modern research, the significance of stagnation-heat-damage in the occurrence, development, diagnosis and treatment of pre-diabetes was explored, and a medical case was attached to prove its effect. [Results] Stagnation-heat-damage is an important pathological basis of the pre-diabetes, in which improper diet and stagnation of the spleen and stomach are the initial factors, sthenic fire consuming vital Qi and stagnation of heat injuring the spleen are the central links, and overuse is the cause of strain, and spleen deficiency is the damage. Stagnation-heat-damage is closely related to the formation of insulin resistance. Because of pathogenesis, formulate treatment and determine prescription, it take eliminating stagnation, clearing heat and preventing damage as the main treatment methods of pre-diabetes, with reference to the ancient prescription Yuye Decoction, Pidan Jiangtang Formula is created and used for the treatment of pre-diabetes with good effect. A typical clinical case attached was diagnosed as pre-diabetes by western medicine, and Pidan by the combination of the four diagnostic methods of traditional Chinese medicine, the syndrome differentiation was spleen-stomach stagnation, spleen injury due to stagnation of heat. The treatment was to eliminate stagnation and clear away heat, strengthen the spleen and invigorate Qi, and the effect of modified Pidan Jiangtang Formula was good. [Conclusion] Stagnation-heat-damage is important pathological factor in the formation of pre-diabetes, and Pidan Jiangtang Formula, which is formulated by eliminating stagnation, clearing heat and preventing damage, is clinically effective.