中医临床研究2025，Vol.17Issue(22)：117-122,6.DOI:10.3969/j.issn.1674-7860.2025.22.015
基于"形气神"三位一体生命观探讨糖尿病脑病病机及诊疗策略
Exploring the pathogenesis and therapeutic strategies of diabetic encephalopathy based on the trinity life concept of"Xing-Qi-Shen"
摘要
Abstract
The Xing(形)-Qi(气)-Shen(神)trinity life concept in traditional Chinese medicine(TCM)serves as the core connotation for interpreting life activities,emphasizing the dynamic unity of physical structure,Qi transformation function,and spiritual-mental regulation.Rooted in the dialectical relationship among the three factors,namely"Xing is the residence of Qi and Shen","Qi is the pivot connecting Xing and Shen",and"Shen governs Xing and Qi",a life model of matter-energy-information interaction is constructed.Diabetic encephalopathy,as a severe complication of prolonged diabetes affecting the brain,is characterized by cognitive decline and emotional disorders,with pathological mechanisms closely associated with neuroinflammation,metabolic dysfunction,and neural network damage induced by hyperglycemia.Based on the original thinking of TCM,the team posits that the pathogenesis of diabetic encephalopathy follows the sequential pathogenic pathway system of"Xing damage-Qi disorder-Shen depletion".During the stage of Xing damage,due to dry-heat injuring body fluid and Qi deficiency and blood stasis in diabetes,metabolic turbid toxins are obstructed in cerebral collaterals,and the blood-brain barrier is damaged,resulting in the insufficiency of the marrow sea.During the stage of Qi disorder,dysfunction of the middle energizer disrupts the balance of clear Yang(阳)ascending and turbid Yin(阴)descending,leading to inadequate brain nourishment,internal accumulation of phlegm-stasis,and reduced cerebral glucose metabolism.During the stage of Shen depletion,kidney essence deficiency weakens the brain's foundational support,while heart-kidney disharmony disrupts spiritual-mental control,impairing neural plasticity and manifesting as memory and executive function disorders.The treatment adopts a triune synergistic approach.First,adjusting Xing to consolidate the root,namely,using insect-derived medicines to break blood stasis and unblock collaterals,and combining with animal-based tonics to replenish essence and marrow to repair neural microstructures.Second,regulating Qi to restore the pivot,specifically,the method of elevating clear Yang and descending turbid Yin is used to regulate middle energizer Qi to ameliorate insulin resistance and cerebral energy metabolism.Third,regulating Shen to open the orifices,specifically,the method of brain-nourishing and wisdom-enhancing is used to tonify heart-kidney and restore sensory clarity,ameliorating hippocampal neuronal injury and synaptic plasticity.This three-tier intervention of"consolidating Xing-restoring Qi transformation-awakening Shen"offers a novel integrative approach of combining disease and syndrome and treating both the body and Shen in the prevention and treatment of diabetic encephalopathy.关键词
形气神/糖尿病脑病/病机/治疗策略/机制探讨Key words
Xing-Qi-Shen/Diabetic encephalopathy/Pathogenesis/Therapeutic strategy/Mechanistic exploration分类
医药卫生引用本文复制引用
王珂然,柴超,顾庆娇,李町,王怡,刘婉怡,梁永林..基于"形气神"三位一体生命观探讨糖尿病脑病病机及诊疗策略[J].中医临床研究,2025,17(22):117-122,6.基金项目
国家社会科学基金项目(18XMZ031). （18XMZ031）
