裴瑞霞治疗2型糖尿病合并高尿酸血症经验

PEI Ruixia’s Experience on Treating Type 2 Diabetes Mellitus Complicated with Hyperuricemia

主要从西安市名中医裴瑞霞主任医师,通过结合国家级名老中医高上林的学术思想,与长期临床实践总结的学术经验,而诊疗2型糖尿病合并高尿酸血症方向进行论述。裴老师诊病崇尚"气机升降失调之病机""三因制宜"以及"治未病"思想,因此在临床上常常运用上述3种学术思想进行辨证施治。她认为部分2型糖尿病合并高尿酸血症早期,可通过辨证论治,从而达到气机调和、阴平阳秘的平和状态,帮助人体解除高血糖、高尿酸血症的状态。目前,这两种病合而并发在临床十分常见,裴老师认为它们在现代医学都属于内分泌代谢性疾病,具体分属两种疾病,目前西医发病原因、发病机制尚不清楚,可以明确的是均与饮食有关,但是裴老师认为从中医思路进行辨治时,究其根本,始因饮食不节,影响气机运行,最终导致气机升降失调,致脾胃虚弱,脾升胃降功能减退,导致湿热、痰浊、瘀血内生,阻滞经络、关节、甚至脏腑,从而发病,因此在治疗时立足于调畅气机,健脾和胃,兼清利湿热、化痰泄浊、活血化瘀等治疗方法,裴老师在临床辨治时,紧扣病因病机,善于把握恩师"见脏休治脏,见腑休治腑"的重要思想,善用经方,组方简洁,用药轻灵,经过临床初探,发现着手成春。

This article mainly discussed the chief physician PEI Ruixias experience on diagnosis and treatment of type 2 diabetes mellitus complicated with hyperuricemia. PEI Ruixia is a famous traditional Chinese medicine in Shaanxi Province.Through combining the academic thought of the national famous Chinese medicine physician GAO Shanglin in Enshi and long-term clinical practice,chief physician PEI advocates the thought of " Qi movement disorder being the pathogenesis", " adjusting measures to three factors" and " treating diseases before they are onset". Therefore,the above three academic ideas are often used in clinic for syndrome differentiation and treatment. She believes that some patients with early type 2 diabetes mellitus complicated with hyperuricemia can be treated by syndrome differentiation of traditional Chinese medicine,so as to achieve the balance of Qi,body fluid,Yin and Yang,and help the body relieve the state of hyperglycemia and hyperuricemia. At present,the combination of these two diseases is very common in clinical practice. Chief physician PEI believes that they belong to endocrine and metabolic diseases in modern medicine. They are specifically divided into two diseases. At present,the etiology and pathogenesis of Western medicine are not clear. It is clear that both diseases are related to diet,but chief physician PEI believes that we should differentiate them from the thinking of traditional Chinese medicine. The root cause of the disease is inappropriate diet,which affects the movement of Qiand eventually leads to the disorder of Qi,deficiency of spleen and stomach,hypofunction of ascending and descending of spleen and stomach,endogenous damp-heat,phlegm turbidity and blood stasis,obstruction of meridians,joints and even Zang-fu organs,and thus causing the disease. Therefore,the treatment is based on regulating Qi,invigorating spleen and stomach. Chief physician PEI is good at grasping the important idea of " not treating Zang-organs or Fu-organs when there are manifestation of Zang or Fu organs",making good use of classical prescriptions,concise prescriptions and light medication. After preliminary clinical exploration,it is effective.