从肝脾论治消渴郁证

Treating Diabetes Mellitus from Liver and Spleen

糖尿病患者常常合并有焦虑、抑郁等情绪障碍,这些负性情绪可通过降低患者的治疗依从性,对血糖控制起负面作用,对病情转归产生消极影响。临床上关于糖尿病的研究多专注于血糖的控制及其并发症的防治,对疾病本身带来的精神和情绪的变化关注较少。糖尿病患者合并情绪障碍,属于中医学“消渴病郁证”的范畴。《郁证门》中提到:郁证大多为七情所伤,以致肝失疏泄,脾失运化,从而导致气血阴阳失调而成。作者结合临床跟诊所见,认为消渴郁证总病机为气机不畅,主要涉及肝、脾二脏,在治疗上以调畅气机为基本原则,疏肝理气、运脾调气,从而干预消渴郁证。改善糖尿病患者的抑郁、焦虑等情绪障碍,不但有助于提高患者的生活质量,也有助于糖尿病的控制。

Diabetes patients often have emotional disorders such as anxiety and depression.These negative emotions can negatively affect blood sugar control by reducing patients’compliance with treatment,and have a negative impact on the outcome of the disease.Clinical research on diabetes is mostly focused on blood sugar control and the prevention and treatment of its complications,and less attention has been paid to the mental and emotional changes brought about by the disease itself.Diabetes patients with emotional disturbances belong to the category of“Diabetes and depression syndrome”in Chinese medicine.It is mentioned in“Yu Zheng Men”that most of the depression syndromes are caused by the seven emotions,resulting in the loss of the liver and the spleen,which leads to the imbalance of qi and blood.Based on clinical experience and clinic visits,the author believes that the total pathogenesis of the Xiaokeqi depression syndrome is poor Qi,which mainly involves the liver and spleen.In the treatment,the basic principle is to smooth the Qi and regulate the Qi,and regulate the Qi.So as to interfere with the syndrome of diabetic depression.Improving mood disorders such as depression and anxiety in diabetic patients will not only help improve the quality of life of patients,but also help control diabetes.