基于《黄帝内经》对谷物精微转化的阐述探究糖尿病的病机

Exploration on the pathogenesis of diabetes based on the exposition of cereal essence transformation in Huangdi Neijing

文章以《黄帝内经》对谷物精微转化的阐述为线索,探究糖尿病的病机。分析得知,谷物精微通过"脉"的运送和"三焦腠理"的交汇、往来,进入脏腑后转化为卫气、营血、宗气及"精(包括形)"。多种原因引起的脾的阳旺阴虚,使脾的"阴藏"能力下降(脾不藏精),即谷物精微向"精"的转化出现异常;导致以葡萄糖为主要成分的谷物精微在经脉、三焦腠理中过多、过久的滞留,即血糖升高。进一步的分析还发现"脾不藏精"贯穿于糖尿病发生、发展的全过程,是糖尿病病机中的核心;而"脾不藏精"及谷物精微(血糖)过多、过久滞留于经脉,三焦腠理对脏腑、气血的损伤,构成了糖尿病临床各复杂证型病机中的主要部分。

This article explored the pathogenesis of diabetes by means of analyzing cereal essence transformations written in Huangdi Neijing. It was found that the cereal essence is firstly transported into viscera by the transportation of ‘vessel’ and exchange at ‘Sanjiao Couli’, and secondly transformed into defensive qi, nutrient-blood, pectoral qi and ‘essence(including body form)’. Due to a variety of reasons, the spleen qin deficiency and yang excess make its ‘yin-storing’ ability weakened(the spleen does not store essence). That means the transformation of cereal essence to human essence becomes abnormal. As a result, the cereal essence, of which glucose is the main component, is retained too much and too long in blood vessels, Sanjiao Couli, that is hyperglycemia. With further analysis, it was also found that ‘spleen does not store essence’ is the core of the pathogenesis of diabetes because it runs through the whole process including the occurrence and development of diabetes. The injuries of viscera, qi and blood, caused by ‘spleen does not store essence’ and excessive and long-term retention of cereal essence(blood glucose) in blood vessels, Sanjiao Couli are the main part of the pathogenesis of various complex syndromes of diabetes.