基于“湿火”理论探讨糖尿病合并冠心病的诊治

Explore the Diagnosis and Treatment of Diabetes Mellitus Complicated with Coronary Heart Disease Based on the “Wet Fire” Theory

[目的]基于“湿火”理论探究糖尿病合并冠心病的临床治疗方法。[方法]以“湿火”理论内涵为着手点,基于古今文献,分析论证“湿火”与糖尿病合并冠心病病理过程的关系,总结出从“湿火”治疗糖尿病合并冠心病的原则,并附上一则医案予以佐证。[结果]糖尿病合并冠心病在中医学属于消渴合并胸痹的范畴,“湿火”是其重要病机,中医学以“火热”并谈,然“湿火”“湿热”两异,“湿火”为湿热伤阴,因此应益气养阴以清“湿火”,进而治疗糖尿病合并冠心病。目前临床上鲜有基于“湿火”理论指导糖尿病合并冠心病治疗的报道。所列举医案即为“湿火”所致,以益气养阴为治法,治疗后症状改善明显。[结论]从“湿火”论治糖尿病合并冠心病,并予以临证加减,疗效颇佳,可为医者提供新颖的治疗思路。

[Objective] To explore the clinical treatment of diabetes mellitus complicated with coronary heart disease based on the “wet fire” theory. [Methods] Taking the theoretical connotation of “wet fire” as the starting point, the relationship between “wet fire” and the pathological process of diabetes mellitus complicated with coronary heart disease was analyzed and demonstrated based on ancient and modern literature, the treatment principles of treating diabetes mellitus complicated with coronary heart disease from “wet fire” were concluded, and a medical case was discussed to prove. [Results] Diabetes mellitus complicated with coronary heart disease in traditional Chinese medicine(TCM) belongs to the scope of thirst and thoracic obstruction, “wet fire” is its important mechanism. Fire and heat are often discussed together in TCM, but “wet fire” and “damp heat” are different, “wet fire” means Yin fluid damage caused by damp heat. Therefore, the treatment of diabetes mellitus complicated with coronary heart disease should be supplementing Qi and nourishing Yin to clear “wet fire”. At present, there are few reports based on the theory of “wet fire” to guide the treatment of diabetes mellitus complicated with coronary heart disease in clinical practice. The listed medical cases were caused by “wet fire”, the treatment method was to supplement Qi and nourish Yin, and the symptoms were relieved significantly. [Conclusion] From the “wet fire” theory to treating diabetes mellitus complicated with coronary heart disease and adding or subtracting from the evidence, the effect is quite good, which can provide novel treatment ideas for doctors.