仝小林院士运用“态靶辨证”理论治疗糖尿病重度胃瘫经验

Experience of Academician TONG Xiaolin in treating severe diabetic gastroparesis by using"differentiation and treatment based on state-target"

糖尿病胃瘫是一种常见的糖尿病患者胃肠道并发症,临床上重症患者较多,但药物治疗存在一定的局限性。本文总结仝小林院士运用“态靶辨证”理论治疗糖尿病重度胃瘫的临证经验,仝小林院士认为其关键病机在于脾胃虚寒,以“阳虚”与“气机失调”为着眼点,主张“温阳益气”为治疗总则。以附子理中汤作为调节糖尿病胃瘫调“寒态”的代表方,有温阳散寒、益气健脾之效,方中附子、干姜为症靶要药。临床上运用附子理中汤随症加减,为糖尿病重度胃瘫的治疗提供临床指导依据。

Diabetic gastroparesis is a common gastrointestinal complication in diabetic patients.There are many severe patients in clinical practice,but there are some limitations in drug treatment.This paper summarizes Academician TONG Xiaolin's clinical experience in treating severe diabetic gastroparesis with the theory of"differentiation and treatment based on state-target"and holds that the key pathogenesis lies in the deficiency of spleen and stomach,and that"warming Yang and benefiting Qi"should be the general treatment principle.Fuzi Lizhong decoction is a representative prescription to regulate the"cold state"of severe diabetic gastroparesis.It has the effect of warming Yang and dispelling cold,supplementing Qi and strengthening spleen.The clinical application of Fuzi Lizhong decoction with the increase and decrease of the disease,to provide clinical guidance for severe diabetic gastroparesis.