从“气食少火”理论探析糖尿病心肌病病机演变与能量代谢特点

Pathogenesis evolution and energy metabolism characteristics of diabetic cardiomyopathy from the theory of"qi is generated by moderate fire"

糖尿病心肌病(diabetic cardiomyopathy,DCM)作为糖尿病患者心血管严重并发症之一,具有较高的发病率和病死率。心脏能量代谢紊乱被认为是DCM病变的关键因素,这与中医“气食少火”理论密切相关。少火的消长贯穿本病病程始终,机体内壮火与少火相争的动态过程构成了DCM的3个发展阶段:代偿期的壮火渐盛与少火耗损,失代偿期的壮火燔炽与痰瘀形成,衰竭期的少火衰微与神机涣散。本文基于“气食少火”理论,分析DCM的能量代谢变化,阐明其中医证候特点,并探讨通过纠正心肌异常能量代谢中断DCM疾病链条,延缓其临床进展,为临床治疗提供思路。

Diabetic cardiomyopathy(DCM),as one of the severe cardiovascular complications in diabetic patients,exhibits high incidence and mortality rates.Disturbed cardiac energy metabolism is considered a key factor in the pathogenesis of DCM,closely related to the theory of"qi is generated by moderate fire"in Chinese medicine.The waxing and waning of moderate fire permeates the entire course of the disease,and the dynamic interplay between hyperactive fire and moderate fire within the body constitutes the three stages of DCM,namely,the compensatory stage with the gradual rise of hyperactive fire and depletion of moderate fire,the decompensatory stage with exuberant hyperactive fire and the formation of phlegm and blood stasis,and the failure stage with declining moderate fire and dissipation of vital functions.Based on the theory of"qi is generated by moderate fire",this paper analyzes the changes in energy metabolism in DCM,elucidates its TCM pattern characteristics,and explores the interruption of the disease chain of DCM by correcting abnormal myocardial energy metabolism,aiming to delay its clinical progression,and provide insights for clinical treatment.