基于《金匮要略》脾肾之虚劳病机探讨糖尿病前期的治法

Treatment of Pre-diabetes by Principles Based on the Pathogenesis of Spleen and Kidney Deficiency in Synopsis of the Golden Chamber

《金匮要略》中论述了虚劳病证的理法方药,分析后可知虚劳病机在脏腑角度上以脾肾之虚劳为关键环节。现代糖尿病前期的发病也常与虚损有关,通过分析《金匮要略》中脾肾的虚劳病机与糖尿病前期的相互联系,可得出二者在内在因素上有一定程度的重合与呼应。因此糖尿病前期的辨证论治可以从脾肾虚劳的角度出发,结合具体临床症状,抓住核心病机,采用温中健脾、温阳补肾和脾肾同补的治法,选用《金匮要略》中相关的针对脾肾的补益方剂例如小建中汤、肾气丸等进行治疗。从脾肾虚劳论治糖尿病前期,或对临床各类内科疾病的慢性调理具有一定价值与意义。

The"Synopsis of the Golden Chamber"discusses the principles,formulas,and medicines of deficiency and fatigue syndrome.After analysis,it can be concluded that the key link in the pathogenesis of deficiency and fatigue from the perspective of organs is the deficiency and fatigue of the spleen and kidney.The onset of modern pre-diabetes is also often related to deficiency and damage.By analyzing the correlation between the pathogenesis of spleen and kidney deficiency and pre-diabetes in Synopsis of the Golden Chamber,it can be concluded that these two have a certain degree of overlap and echo in internal factors.Therefore,the syndrome differentiation and treatment of pre-diabetes can proceed from the point of view of spleen and kidney deficiency and fatigue,combined with specific clinical symptoms,grasp the core pathogenesis,adopt the treatment method of warming the middle and strengthening the spleen,warming the Yang and tonifying the kidney,and spleen and kidney tonifying together,and select the relevant prescriptions for spleen and kidney in the Golden Chamber Synopsis,such as Xiaojianzhong Decoction,Shenqi Pill,etc.It has certain value and significance to treat the pre-diabetes from the deficiency of spleen and kidney,or to regulate the chronic condition of various clinical medical diseases.