马万千名老中医治疗消渴病临床经验撷萃

Clinical experience of famous veteran TCM practitioner MA Wanqian in treating diabetes

消渴首见于《黄帝内经》,其中对消渴的病因病机及其辨证施治多有论述,为后世辨治消渴病及其变证奠定了重要的理论基础。马万千主任医师从事中医内科临床工作40余年,对消渴病的诊疗思路和遣方用药皆有独特见解。马师认为消渴病由先天禀赋异常,复因饮食不节、劳逸失度、情志失调、感受外邪诱发,临床以多饮、多食、多尿、乏力、消瘦,或尿有甜味为典型表现,其主要病机为阴虚为本,燥热为标,瘀血贯穿消渴发病始终。治疗上应以滋阴清热、活血化瘀为治疗大法,故临床应用自拟消渴方加减辨治。此外,马师临证还注重饮食调控、体育锻炼及情志调节来辅佐药物治疗,效如桴鼓。文章对马万千主任医师临床运用自拟消渴方加减的临床经验进行系统总结,以期为临床治疗本病提供新思路和方法。

Diabetes is first seen in Huangdi Neijing(《黄帝内经》),in which there are many discussions on the etiology and pathogenesis of diabetes and its treatment based on syndrome differentiation,laying an important theoretical foundation for later generations to differentiate and treat diabetes and its changes.Chief Physician MA Wanqian has been engaged in the clinical work of TCM internal medicine for more than 40 years,and has unique insights into the diagnosis and treatment ideas and prescriptions for diabetes.Chief Physician MA Wanqian believes that diabetes is caused by abnormal congenital endowments,and is also caused by improper diet,overworked or overly comfortable,emotional disorders,and feelings of exogenous pathogens.Its typical clinical manifestations include polydipsia,polyphagia,polyuria,fatigue,weight loss,or sweet urine.He thinks that its main pathogenesis is Yin(阴)deficiency,that its superficial symptom is dryness-heat,and that blood stasis runs through the onset of diabetes.In the treatment,nourishing Yin and clearing heat,promoting blood circulation and removing blood stasis should be the major methods.The Xiaoke prescription(消渴方)is applied in clinical practice.In addition,Mr.MA also pays attention to diet regulation,physical exercise and emotional regulation to assist drug treatment,and the curative effect is remarkable.In this article,the clinical experience of Chief Physician MA Wanqian in treating the disease with the Xiaoke prescription is summarized systematically,in order to provide new ideas and methods for the clinical treatment of the disease.