| 黄琦,田丰源.消渴演变病机探析及临证经验[J].浙江中医药大学学报,2019,43(6):523-526. |
| 消渴演变病机探析及临证经验 |
| Pathogenesis and Clinical Experience in Wasting-thirst with the Evolution Process |
| DOI：10.16466/j.issn1005-5509.2019.06.001 |
| 中文关键词: 糖尿病 瘅证 消渴 杨继荪 治疗经验 温病学说 痰瘀论 治未病 |
| 英文关键词: diabetes mellitus pure heat wasting-thirst YANG Jisun experience of treatment febrile diseases theory the theory of phlegm and blood stasis preventive treatment of diseases |
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| 中文摘要: |
| [目的]承杨继荪先生理论及笔者多年临证经验，思探消渴成病传变之机。[方法] 钻研经典，结合多年经验，分析从医经验及病案以认识消渴全程发展之病因病机，阐述瘅症发展为消渴进而生变证的病机转播，分析经典方对证及功用并附案举证。[结果]消渴病程冗长，转进繁杂。土壅为先，方以解郁，气郁为六郁之首，施柴胡加龙骨牡蛎汤。郁久生火，应以清热，阳明胃热最亢进葛根芩连汤。久贻耗精，以对补益，分论虚实阴阳以填亏。湿浊痰瘀，变证终成，四因累久皆损脉络，化湿利浊清痰解瘀应贯穿消渴始末。治消不应拘燥热阴虚，诸因皆能成消，应重清痰化瘀。所举案例为痰热结瘀所致脾瘅消渴，治以黄连温胆汤分消湿热，流通中焦，苦温并奏，另佐郁金破血理气通经，终获良效。[结论]消渴善变，治消当阻其传变。未病先防，卸化肥甘以避免成消；既病防变，阻遏痰瘀以拒生变证；瘥后防复，消解变证防患复生。 |
| 英文摘要: |
| [Objective] To explore the speculation of wasting-thirst, based on YANG Jisun's theory and the auctorial experience for ages about the therapy of wasting-thirst.[Methods]This paper analyzes the understanding of the pathogeny and pathogenesis of the whole process of wasting-thirst, expounds the pathogenesis of the development of pure heat to wasting-thirst and its transformation of syndromes, using years of clinical experience, and analyzes the effects of the classical prescription on syndromes. And a case was presented to prove it.[Result]Combined with classic theories and personal experience, the course of wasting-thirst is lengthy, turning into multifarious easily. To expatiate its course, the congestion of earth is the first step of wasting-thirst, dealt with relieving depression. Qi depression is primary in six depressions. The main formula is Chaihu Jia Longgu Muli Tang. Qi depression becomes inner fire instead within long-term basis. Yangming heat is the most excessive. The main formula is Gegeng Qinlian Tang. Long term illness turns to asthenia. Distinguish between Yin and Yang in tonic way. Venation is damaged while dampness, turbidity, sputum and blood stasis are generated, eliminating four factors throughout the course of wasting-thirst. As for treating diabetes, there are many ways leading to wasting-thirst, we should not stick to the syndrome of dryness-heat and Yin deficiency stubbornly. And the case in this article have obtained good result.[Conclusion]Because of the fickleness of wasting-thirst, eliminating its transmission change is the key during the treatment. Pay attention to cleaning phlegm and removing blood stasis. Try to avoid its development via digesting grease and sugar. Preventing pathological changes in treating ones that already sick, try to stop phlegm and blood stasis to prevent the symptoms, address further changes and prevent them from relapsing for ones mostly cured. |
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