仝小林运用大黄、黄连、焦槟榔治疗2型糖尿病胃肠实热证经验

Tong Xiaolin’s experience in using rhubarb root and rhizome,golden thread and areca seed to treat type 2 diabetes with the gastrointestinal excessive heat syndrome

糖尿病患者早期大多有嗜食肥甘厚味的习惯,郁热内阻脾胃,多表现为中焦胃肠实热证。仝小林院士认为糖尿病早中期的核心病机是中满内热,以热态为主,胃肠实热证是其主要证型,口干渴、口苦口臭、大便干结为症状靶,血糖升高为指标靶,治法以泻热除满、行气通膵为主,创治疗糖尿病的经验小方通膵饮,全方由生大黄、黄连、焦槟榔三味组成,态靶同调,方简效著。方中生大黄为泻热导滞通腑的要药,临床常用量3~15 g;黄连为苦寒之最,善清中焦郁热,又是确有疗效的降糖靶药,临床常用量为15~30 g;槟榔行气消积,临床常用量6~15 g。

In the early stage of diabetes,most of the patients have the habit of eating too much food with the greasy,sweet and surfeit fl avours,leading to the syndrome of gastrointestinal stagnated heat in the spleen and stomach,which is mostly manifested as the syndrome of excessive heat in the middle jiao.Therefore,Academician Tong Xiaolin believes that the core pathogenesis of diabetes in its early and middle stages is the fl atulence and endogenous heat,mainly in a heat state,with the gastrointestinal excessive heat as its chief syndrome,with dry mouth,bitter taste in mouth,halitosis and dry stool as its symptom targets,and with the increase in blood glucose as its index target,with purging heat and relieving fl atulence,promoting qi-fl owing and activating pancreas as its primary treatment method.He makes a minor experiential prescription Tongcui Yin for the treatment of diabetes mellitus,which is composed of raw rhubarb root and rhizome,golden thread and areca seed.Simple as the minor prescription is,it is rather eff ective in regulating the disease state and target simultaneously.In the prescription,raw rhubarb root and rhizome is the main medicine for purging heat,removing stagnation and clearing the organs,with a common clinical dosage of 3-15 g.Golden thread,with the most bitter taste and cold nature,is good at clearing the stagnated heat in the middle jiao,and is also an eff ective hypoglycemic target drug,with a common clinical dosage of 15-30 g.Areca seed can promote qi movement and relieve food retention,with a common clinical dosage of 6-15 g.