杨叔禹主任研究闽南地区人群代谢性心身疾病的证素特点及临床思路总结

Director Yang Shuyu’s study on the syndrome element characteristics and clinical thinking of metabolic psychosomatic diseases in the population of southern Fujian

代谢性心身疾病是一组以代谢指征紊乱为临床表现的心身疾病,其发病涉及生理、心理及社会因素。该类疾病病程绵长、终身难愈,目前临床多关注躯体症状,常忽视患者社会心理因素,这不利于患者的康复。中医对于此类疾病的诊疗基于整体观与辨证论治,由于证型繁多,导致医者无法认清疾病本质。证素辨证的应用将使得中医学者对疾病病程的演变具有更客观的量化标准。因此,本文总结了杨叔禹主任带领团队围绕闽南地区人群开展的多项临床研究成果,发现糖尿病前期与2型糖尿病患者的中医病位证素集中在肝、脾、肾,病性证素集中在痰、湿、热;而中医证素肝贯穿于2型糖尿病并发症的发生发展过程;非酒精性脂肪性肝病的病位主要涉及肝、脾证素,病性涉及痰、湿、热。同时,本文还概括了杨叔禹主任以维持肝主疏泄功能正常为核心的辨治代谢性心身疾病的诊疗思路,以飨同道。

Metabolic psychosomatic diseases are a group of psychosomatic diseases characterized by metabolic disorder,and their onset involves physiological,psychological,and social factors.This kind of disease has a long course and is difficult to cure for life.Currently,clinical practice focuses more on physical symptoms and often overlooks the social and psychological factors of patients,which is not conducive to their recovery.The diagnosis and treatment of this kind of disease in traditional Chinese medicine is based on a holistic view and syndrome differentiation.Because of the variety of syndrome types,doctors are unable to recognize the essence of the disease.The application of syndrome element differentiation will make TCM scholars have more objective quantitative standards for the evolution of disease course.Therefore,this paper summarizes a number of clinical research results of the team led by Director Yang Shuyu around the population in southern Fujian,and finds that the TCM syndrome elements of pre-diabetes and type 2 diabetes are concentrated in liver,spleen and kidney,and the syndrome elements of disease are concentrated in phlegm,dampness and heat.Traditional Chinese medicine syndrome elements liver runs through the occurrence and development of complications of type 2 diabetes.The disease location of nonalcoholic fatty liver mainly involves liver and spleen syndrome elements,and the disease nature involves phlegm,dampness and heat.At the same time,this paper also summarizes Yang Shuyu’s thoughts of diagnosis and treatment of metabolic psychosomatic diseases with the core of maintaining the normal function of liver governs free coursing,to benefit more same people.