从“伏邪”理论探讨糖尿病大血管病变的防治

Investigation of prevention and cure of diabetic macroangiopathy in incubative pathogen theory

糖尿病大血管病变属于中医"脉痹"范畴,先天禀赋不足、饮食不节、情志不畅、房事不节、劳欲过度等病因导致水液代谢失常,痰浊、瘀血阻滞脉络,致使糖尿病大血管病变的发生。中医的"伏邪"是指藏于体内而不立即发病的病邪,致使糖尿病大血管病变发病的痰浊、瘀血是伏邪的主要物质,经脉是伏邪隐匿之所,正气亏虚是伏邪致病的必要条件。而糖尿病大血管病变在未发病之前,痰浊、瘀血之邪已经伏于脉络,伏邪经过长时间的累积,正邪的平衡被打破,终致痰瘀痼结,损伤脉络。因此,在伏邪引而未发之时,应予以积极防治,以延缓疾病的发生发展。谢春光教授应用具有养阴益气活血功效的参芪复方以补虚为主,化痰活血为辅,使"痰瘀"伏匿之邪消散,阻滞其对血管的持续损伤,达到防治糖尿病大血管病变的作用。

Diabetic macroangiopathy belongs to the category of＂vascular arthralgia＂of Chinese medicine. Lack of innate endowment,improper diet,affect-mind dissatisfaction,sexual strain and excessive labor can lead to fluid metabolism disorders. The phlegm and blood stasis block the vein,causing the occurrence of diabetic macroangiopathy. The＂incubative pathogen＂refers to the pathogenic factors hidden in the body and not immediately onset. The precondition of incubative emergence is deficiency of vital qi,the principal intergrant is phlegm and blood stasis,arteries and veins are main place the incubation hided. But before the onset of diabetic macroangiopathy,the phlegm and blood stasis has hidden in the vein. After a long time of accumulation of incubative pathogen,the balance of vital energy and evil qi is broken,leading to the damage of the vein. Before the incubation break out,positive treatment and cure should be given. Professor XIE Chunguang applied Shenqi decoction to reach the role of prevention and treatment of diabetic macroangiopathy. The Shenqi decoction has the effect of nourishing yin,tonifying qi and activating blood,mainly tonifying deficiency,secondly reducing phlegm and activating blood,dissipating incubative phlegm and stagnation,and blocking the sustained damage to blood vessels.