从“湿热、血瘀、脾虚”辨治糖尿病合并肛瘘

Differentiation and Treatment of Diabetes Mellitus Combined with Anal Fistula from"Damp Heat,Blood Stasis and Spleen Deficiency"

与普通肛瘘相比,糖尿病合并肛瘘在临床中更需要特别关注。本文基于中医典籍,结合现代研究及临床经验,从“湿热、血瘀、脾虚”角度探析糖尿病合并肛瘘的辨治,认为“湿热、血瘀、脾虚”为糖尿病合并肛瘘的核心病机,脾虚为本,湿热为标,随着病程进展各有侧重。起病初期,以湿热为主,病程中后期,多以脾虚为主,血瘀贯穿全程。治疗应辨清虚实,随证遣方用药。

Compared with common anal fistula,diabetes mellitus combined with anal fistula needs more special attention in clinical practice.Based on the classics of traditional Chinese medicine,combined with modern research and clinical experience,this paper analyzes the differentiation and treatment of diabetes mellitus complicated with anal fistula from the perspective of"damp heat,blood stasis and spleen deficiency".It is believed that"damp heat,blood stasis and spleen deficiency"are the core pathogenesis of diabetes mellitus complicated with anal fistula.Spleen deficiency is the root cause and damp heat is the manifestation,with the progress of the disease,each has its own emphasis.At the beginning of the disease,it is mainly damp heat.In the middle and late stages of the disease,it is mainly spleen deficiency,and blood stasis runs through the whole process.Treatment should distinguish between deficiency and excess,with the evidence of prescription medication.