辛味药在消渴治疗中的应用

Application of Pungent Medicines in Treatment of Xiaoke Disease

消渴病机虽以阴虚内热为主,但仍应重视三焦功能在疾病发展中的作用。三焦燥郁,气机不行、津液不布,甚至化痰生瘀、津亏耗血,则病情加重,变证丛生。临证时应重视辛味药的使用,以其“辛以行气”“辛以润之”的功效调畅三焦,以助气机畅达、津液输布。故可在诸养阴润燥药中加入辛味药,一可防止诸养阴之品滋腻,二可疏通三焦、振奋气机、促进气化,以除三焦郁滞,并应根据三焦病位的不同而选取辛寒、辛苦、辛温等配伍方法增强药效。然而,用药之时也需注意辛味药用量不易过大,旨在发散三焦郁滞,疏通气机、宣散郁热、布达津液,且用药时间不宜过久,应中病即止,以防耗伤正气。

Although the pathogenesis of Xiaoke disease is mainly characterized by Yin deficiency and internal Heat,attention should still be paid to the role of the Three Jiao function in the development of the disease.If the Three Jiao function is dry and depressed,the Qi mechanism is not functioning properly,the body Fluid is not distributed,and even Phlegm and blood stasis are produced as well as the body Fluid is deficient and blood is consumed,the condition will worsen and symptoms will cluster.In clinical practice,attention should be paid to the use of pungent medicines,by using their"being pungent to promote Qi circulation"and"being pungent to nourish"effects to regulate the Three Jiao,to assist in the smooth flow of Qi and the distribution of body Fluids.Therefore,pungent medicines can be added to various medicines functioning in nourishing Yin and moistening Dryness.Firstly,it can prevent the nourishing Yin medicines from becoming greasy.Secondly,it can dredge the Three Jiao,invigorate the Qi mechanism,promote Qi transformation and eliminate stagnation of the Three Jiao.According to the different disease locations of the Three Jiao,a combination of pungent and Cold,or combination of pungent and bitter,or combination of pungent and Warm method should be used to enhance the efficacy.However,it is also important to note that the amount of pungent medicines should not be little or tiny,aiming to disperse the stagnation of the Three Jiao,clear the Qi mechanism,promote the dissipation of stagnation Heat,and spread body Fluid.Beside,the use of them should not be long and stop using them properly to prevent damage to the Zheng Qi of patients.