2型糖尿病胰岛素抵抗重视从脾论治的思路

Emphasis on Dealing with Spleen for the Treatment of Type 2 Diabetes Mellitus with Insulin Resistance

2型糖尿病胰岛素抵抗属中医学消渴病范畴,其标志是高胰岛素血症,伴有肥胖、高血压、高脂、高粘血症及其他代谢综合征的表现。中医辨证多湿、多痰、多瘀。脾虚湿盛是胰岛素抵抗的病理基础;痰浊瘀血是胰岛素抵抗的病理产物。因此,临床上应重视从脾论治,辨证与辨病相结合,标本兼治,分期分型论治。早期健脾益气、化湿清热;中期健脾化痰、活血祛瘀;晚期健脾补肾、化痰逐瘀通络。

Type 2 Diabetes mellitus with insulin resistance (IR) belongs to the category of 'Xiao Ke ' disease in TCM, which is characterized by hyperinsulinemia and accompanied with obesity, hypertension, hyperlipemia, blood hyperviscosity and other metabolic syndromes. TCM syndrome differentiation showed abundance of damp, phlegm and blood - stasis. Abundance of damp due to spleen - deficiency is the pathological base of IR. and phlegm, turbid substance and blood - stasis are its pathological products. Therefore, dealing with the spleen for the treatment, syndrome differentiation Combined with diagnosis of disease, treating the primary and secondary symptoms simultaneously, and treatment varing with different syndromes and stages should be paid attention clinically. In the early stage, the spleen should be strengthened, qi benefited, damp eliminated, heat cleared. In the middle stage, the spleen should be strengthened, phlegm resovled, blood circulation activated and blood - stasis removed. In the late stage, the spleen should be strengthened, kidney invigorated, phlegm resolved, collateral be dredged.