张仲景治疗消渴的思想探析

Analysis of ZHANG Zhong-jing's treatment on xiaoke disease

目的:分析张仲景对消渴病病因、病机、分型及处方的认识,从而提高中医药治疗消渴病的疗效。方法:对《金匮要略·消渴小便利淋病脉证并治第十三》相关文献进行研究分析和自我临床实践总结。结果:张仲景总结治疗消渴的理、法、方、药对目前临床仍有重要意义。结论:张仲景认为消渴病在病位上涉及肝、脾胃、肾、三焦;病机上本虚标实,主要为气血亏虚,燥热内盛;分型证治上主要为肺热津伤、胃热炽盛、肾阳虚衰、气化不利;在方药上,针对病机制定了白虎加人参汤、调胃承气汤、肾气丸、五苓散等方剂,这些方剂在临床治疗上效果明显,疗效确切,应深入挖掘使用。

Objective:Through the analysis of ZHANG Zhong-jing's experience on the diabetes'treatment's etiologies,pathogenesis,classification and prescription,we can improve curative effect of the Chinese medicine treatment on diabetes.Methods:To study and analyze the literature of Synopsis of golden Chamber,Relieving thirst,Small convenience and Treating the Pulse syndrome of Gonorrhea,and to summarize my clinical practice.Results:ZHANG Zhong-jing's experience on the diabetes'treatment's etiologies,pathogenesis,classification and prescription are still have great clinical significances.Conclusion:ZHANG Zhong-jing believed that diabetes mellitus involves liver,spleen and stomach,kidney and tricoke.In terms of pathogenesis,the main symptoms were deficiencies of qi and blood and internal heat exhaustion.The main symptoms of diabetes'classification were hot fluid injury of lung,heat of stomach,deficiency of kidney's Yang and adverse gasification.According to the pathogenesis,formulations such as White tiger plus ginseng soup,Tiaowei chengqi soup,Shenqi Pill and Wuling Powder were formulated.Those formulations have obvious clinical effects and definite curative effects,should be explored and used further.