中医药治疗2型糖尿病伴失眠的研究综述

A review on TCM treatment of type 2 diabetes mellitus with insomnia

糖尿病是以高血糖为特征的代谢性疾病,近年来受诸多因素影响,在全球范围内糖尿病患病率显著增加,且极易伴发各种急慢性并发症,成为亟待解决的公共卫生难题。由于生理、心理等因素影响,糖尿病伴发失眠患者逐渐增多,糖尿病伴失眠是临床上常见的慢性复合性疾病,严重影响患者生活质量。西医治疗较为局限,主要在控制血糖的基础上加以镇静催眠类药物,不能从根本上解决问题。中医药治疗糖尿病伴失眠临床疗效确切、用药温和、治疗方法多样,患者接受度高。糖尿病伴失眠在中医学里被归为“消渴不寐”范畴,现代医家在对前人认识的基础上,将该病病机概括为阴阳失交。在对糖尿病伴失眠的中医治疗上,诸多医家重视单味药的安神功效及降血糖效果,应用复方随证加减,对症施治,从该病病因病机出发,重视交通心肾、滋阴安神,养血活血等治法,运用交泰丸、黄连阿胶汤、酸枣仁汤、血府逐瘀汤等进行治疗,中西医相结合,内服法与外治法相结合。文章重点从糖尿病伴失眠的病因病机、单味药、中药复方、中西医结合疗法、中医特色疗法等方面对中医药治疗糖尿病伴失眠作一综述,以期为后续研究者临床研究糖尿病伴失眠提供借鉴,为临床治疗本病提供新思路。

Diabetes is a metabolic disease characterized by hyperglycemia.In recent years,due to the influence of many factors,the prevalence of diabetes has increased significantly worldwide,and it is easy to be accompanied by various acute and chronic complications,which has become an urgent public health problem.Due to physiological and psychological factors,the number of patients with diabetes accompanied by insomnia is gradually increasing.Diabetes accompanied by insomnia is a common chronic complex disease in clinical practice,seriously affects the quality of life of patients.Western medicine treatment is relatively limited,mainly applies sedative and hypnotic drugs on the basis of controlling blood glucose,which cannot fundamentally solve the problem.Traditional Chinese medicine has the advantages of definite clinical effects,mild medication,various treatment methods,and high acceptance of patients in the treatment of diabetes with insomnia.In TCM,diabetes accompanied by insomnia is classified as“Ddiabetic insomnia”.Based on previous understanding,modern doctors summarize the pathogenesis of this disease as the imblance between Yin(阴)and Yang(阳).In the TCM treatment of diabetes accompanied by insomnia,many doctors attach importance to the sedative effect and the effect of lowering blood glucose of single flavor medicine.They make application of the addition and reduction of compound prescription according to the syndrome,give symptomatic treatment from the etiology and pathogenesis of the disease,pay attention to the interaction of the heart and kidney,nourishing Yin and calming the spirit,nourishing blood and promoting blood circulation and other treatment methods.The frequently applied prescriptions include Jiaotai Wan(交泰丸),Huanglian Ejiao decoction(黄连阿胶汤),Suanzaoren decoction(酸枣仁汤),Xuefu Zhuyu decoction(血府逐瘀汤).The combination of TCM and Western medicine and combination of internal administration and external treatment are given.The article focuses on the etiology and pathogenesis of diabetes mellitus with insomnia,and reviews the treatment of diabetes mellitus with insomnia,from single medicine,traditional Chinese medicine compound,the integrative medicine,TCM characteristic therapy and other aspects,so as to provide reference for the follow-up clinical research of diabetes mellitus with insomnia,and provide new ideas for the clinical treatment of this disease.