基于《黄帝内经》之“脾瘅”谈糖尿病前期

Exploring Prediabetes through the Lens of “Pi Dan” in “The Yellow Emperor’s Inner Canon”

摘要: 《黄帝内经》是我国现存医学文献中年代最为久远的典籍。它极为系统地阐述了祖国医学的理论准则与学术理念，为中医辨证论治奠定了初步基础。“脾瘅”一词最早出现于《素问·奇病论》卷十三。文中记载：“此五气之溢也，名曰脾瘅……肥者令人内热，甘者令人中满”这清晰地表明脾瘅与脾胃、津液以及肥美食物等因素关联紧密。本文基于《黄帝内经》的脾胃理论，深入剖析脾瘅和糖尿病前期的病因病机，从调理脾胃入手，通过清除体内积聚的湿热秽浊等病理产物，以期为临床中糖尿病前期的预防治疗提供中医药理论支持和辨证思路。

Abstract: The Yellow Emperor’s Inner Canon is the oldest extant medical text in China. It systematically expounds the theoretical principles and academic doctrines of traditional Chinese medicine (TCM), laying the foundational framework for syndrome differentiation and treatment in TCM. The term “Pi Dan” first appears in Volume 13 of “Suwen - Qibing Lun”, which states: “This condition arises from the overflow of the five qi, termed Pi Dan… Rich [fatty] foods induce internal heat, while sweet foods lead to abdominal distension.” This passage clearly illustrates the close relationship between Pi Dan and factors such as spleen-stomach dysfunction, fluid metabolism, and excessive consumption of rich or sweet foods. Grounded in the spleen-stomach theory of “The Yellow Emperor’s Inner Canon”, this study delves into the etiology and pathogenesis of Pi Dan and prediabetes. By emphasizing spleen-stomach regulation and eliminating pathological accumulations such as damp heat, turbidity, and waste, this approach seeks to provide theoretical support and syndrome-differentiation strategies for the prevention and clinical management of prediabetes through TCM principles.