基于“脾-陈气-脉积”探讨糖尿病早期动脉粥样硬化病因病机

Discussion on Etiology and Pathogenesis of Early Atherosclerosis in Diabetes Mellitus Based on"Spleen,Chen Qi and Mai Ji"

大血管病变是糖尿病主要致死原因之一,动脉粥样硬化是其病理基础。中医药治疗糖尿病动脉粥样硬化疗效显著,但缺乏深入系统的病机阐述。根据“癥瘕积聚”理论,本课题组前期提出了“脉积”学说,本文着眼病变早期,认为脾不散精是始动环节,陈气是病理产物和致病因素,陈气聚而不散,损伤血脉形成脉积。治疗上强调早期干预是延缓或逆转病情进展的关键,健脾除陈为基本治则,痰瘀同治应贯穿全程。本文基于“脾-陈气-脉积”病机观,阐释糖尿病早期动脉粥样硬化的中医理论内涵和现代医学外延,为本病的中医药防治提供新思路。

The macrovascular complication is one of the main causes of death in diabetes mellitus,and atherosclerosis is its pathological basis.Traditional Chinese medicine(TCM)has a certain therapeutic effect on diabetic atherosclerosis,but lacking in-depth and systematic pathogenesis."Mai Ji"theory was proposed according to the theory of"Zhengjia-Jiju"early.This paper introduces the dysfunction of the spleen transforming essence is the initial step and Chen Qi is the pathological product and pathogenic factor in the early stage of this disease.Chen Qi’s aggregation and dispersion imbalance damage blood vessels,resulting in the formation of Mai Ji.It is proposed that early intervention is a key measure to delay or reverse disease progression.Regarding the treatment method,it is suggested that strengthening the spleen and eliminating Chen Qi is the basic treatment,and resolving the phlegm and blood stasis should throughout the whole process.Based on the pathogenesis of"Spleen,Chen Qi and Mai Ji",the theoretical connotation of TCM and the modernmedicineextension of early atherosclerosis indiabetic are explained to provide new ideas for the prevention and treatment of TCM.