基于五脏“苦欲补泻”理论从脾探讨糖尿病胃轻瘫的病因病机与辩治思路

Exploring the Etiology and Pathogenesis of Diabetes Gastroparesis and the Thinking of Differentiation and Treatment from Speen Based on the Theory of “Like or Dislike Tonifying and Purgative” of the Five Zang Organs

摘要: 基于五脏“苦欲补泻”理论将脾脏的生理功能及特点与糖尿病胃轻瘫所涉病因病机相结合，以此指导糖尿病胃轻瘫的临床治疗与遣方用药。脾虚是糖尿病胃轻瘫的主要病理因素，脾虚湿盛，脾土不运是糖尿病胃轻瘫的重要病机，在胃轻瘫的发生发展过程中始终与脾脏的病理机制密不可分。以“脾苦湿，急食苦以燥之”作为辩治思路，顺应“苦欲补泻”理论的内涵，根据脾脏的生理特性指导临床上针对糖尿病胃轻瘫辩证分期及治疗，旨在为中医临证诊疗提供新方向，提高临床疗效。

Abstract: Based on the theory of “like or dislike tonifying and purgative” of the five zang organs, this approach integrates the physiological functions and characteristics of the spleen with the etiology and pathogenesis of diabetic gastroparesis to guide its clinical treatment and herbal prescription. Spleen deficiency is the primary pathological factor in diabetic gastroparesis, while spleen deficiency with dampness exuberance and failure of spleen-earth to transport are key pathomechanisms. Throughout the development and progression of gastroparesis, these factors remain closely linked to the pathological mechanisms of the spleen. Guided by the principle that “the spleen is averse to dampness and urgently requires bitter herbs to dry it”, and in accordance with the theory of “like or dislike tonifying and purgative”, the physiological characteristics of the spleen are applied to direct the syndrome differentiation, staging, and treatment of diabetic gastroparesis in clinical practice. This aims to provide a new direction for traditional Chinese medicine diagnosis and treatment, thereby enhancing clinical efficacy.