老年糖尿病患者早期心功能改变的病机与防治对策

Pathogenesis and Preventive Measures of Cardiac Functional Change of the Old Patients with Diabetes in Its Early Stage

消渴病的基本病机是阴虚燥热。若肺阴亏虚 ,燥热内盛 ,影响肺主呼吸之功能 ,导致肺气壅塞 ,不能助心行血 ,可累及心君 ;若胃阴已虚 ,脾胃失于受纳 ,则气血生化乏源 ,可致气血亏虚 ,心失所养 ;肾阴亏虚 ,肾水不能上济于心 ,可致心肾不交 ,病变及心。对老年糖尿病并心功能异常心气虚证的患者 ,治疗上以补益心气为主 ;若为心阳不足之证 ,应注意温补心阳 ,但在温补时不宜过分辛燥或辛散 ,以免更伤阴液 ;心血瘀阻证治应活血化瘀 ;痰瘀阻脉证治疗上则应以活血化瘀及化痰为主。

The basic pathogenesis of diabetes is dryness-heat due to deficiency of yin. The dryness-heat due to deficiency of the lung-yin may influence the function of lung being in charge of respiration, which will result in the obstruction of the lung qi and failure of aiding the blood circulation of heart; the insufficient qi and blood formation due to the deficiency of stomach-yin may lead to the deficiency of qi and blood and the unconsolidation of heart-qi. The deficiency of the kidney-yin may cause the breakdown of the normal physiological coordination between the heart and the kidney. For the old patients with diabetes and abnormal heart function due to the insufficiency of the heart-qi syndrome,the invigoration of the heart-qi should be emphasized in the treatment。For the syndrome due to deficiency of the heart-yang,warming and recuperating the heart-yang should be noted,but in which the excessive dryness or cold dispelling is not suitable. For the syndrome of stagnation of the heart blood,promoting blood circulation by removing blood stasis should be stressed . While for the syndrome of stagnation of phlegm,promoting blood circulation by removing blood stasis and resolving phlegm should be emphasized in the treatment.