北京中医药大学学报2025，Vol.48Issue(1)：8-13,6.DOI:10.3969/j.issn.1006-2157.2025.01.002
气血津液视域下糖尿病时空辨证的序贯诊疗模式刍议
Discussion of sequential diagnosis and treatment model of diabetes mellitus of spatiotemporal syndrome differentiation from the perspective of qi,blood,and fluid
摘要
Abstract
The dysfunction of qi,blood,and fluid underlies the pathology of diabetes mellitus.The symptoms,signs,and physical and chemical indexes of diabetes mellitus patients reflect the duration,degree,primary and secondary pathological state of the abnormal metabolism of qi,blood,and fluid.It is necessary to construct a three-dimensional syndrome differentiation system of diabetes mellitus based on spatial and temporal dimensions.According to the four stages of depression,heat,deficiency,and damage,the location of the disease can be locked into qi,ying,and blood levels.The process reflects the pathological trend of the abnormal metabolism of qi,blood,and fluid:qi depression(prodromal stage:asymptomatic metabolic disorder/early stage of qi level)→ qi heat(initial stage:index stage/late stage of qi level)→ deficiency of both qi and yin(middle stage:symptom stage of three more and one less/stage of ying level)→ damage of zang-fu viscera and meridians(late stage:complication stage/stage of blood level).According to the time process,the treatment principles are proposed as follows:during the early stage of qi level,treatment should focus on strengthening the spleen to regulate qi flow,to prevent the accumulation of glucose;during the late stage of qi level,treatment should focus on clearing heat and resolving turbidity,to remove the stagnated heat caused by glucose;during the stage of ying level,treatment should focus on benefiting qi and nourishing yin,to improve the symptoms about deficiency of both qi and yin;during the stage of blood level,treatment should focus on promoting blood circulation and removing blood stasis,to remove the complication.According to the etiology and pathogenesis of diabetes mellitus,the sequential treatment strategy is thus proposed,which is strengthening the spleen to regulate qi flow,clearing heat and resolving turbidity,benefiting qi and nourishing yin,and promoting blood circulation and removing blood stasis.The compound prescriptions such as Houpo Sanwu Decoction,Baihu Jia Renshen Decoction,Danggui Liuhuang Decoction,and Taohong Siwu Decoction are used with modification in the stage-based treatment.关键词
糖尿病/气血津液视域/时空辨证/序贯诊疗Key words
diabetes mellitus/perspective of qi,blood,and fluid/spatiotemporal syndrome differentiation/sequential diagnosis and treatment分类
医药卫生引用本文复制引用
胡锦浩,孙贵炎,杨宇峰,石岩..气血津液视域下糖尿病时空辨证的序贯诊疗模式刍议[J].北京中医药大学学报,2025,48(1):8-13,6.基金项目
辽宁省科学技术计划项目(No.2023JH2/101300050) Science and Technology Planning Project of Liaoning Province(No.2023JH2/101300050) （No.2023JH2/101300050）
