从脾论治糖尿病性便秘的研究进展

Research Progress on Treating Diabetic Constipation from the Spleen

摘要: 糖尿病性便秘为糖尿病常见的并发症之一，其发病率高，容易反复发作，严重影响患者的生活质量及血糖控制。西医对于糖尿病性便秘的治疗往往选取开塞露、乳果糖等相关药物进行干预，虽疗效快，但在糖尿病患者中，便秘现象发作频繁，反复给予这些药物易使患者产生依赖性，引发焦虑等症。祖国医学认为，脾主运化，为气血生化之源、气机升降之枢，且脾失健运在糖尿病性便秘的整个发病过程中居于核心地位。本文系统梳理从脾论治糖尿病性便秘的理论渊源与病因病机，归纳健脾益气、行气导滞、润肠通便等治法体系，总结中医内治联合中医特色外治的相关临床应用进展，对从脾论治糖尿病性便秘进行系统的综述，为临床治疗2型糖尿病性便秘提供理论依据与指导。

Abstract: Diabetic constipation is one of the common complications of diabetes mellitus. It has a high incidence rate, is prone to recurrent episodes, and severely affects patients’ quality of life and glycemic control. In Western medicine, treatments for diabetic constipation often involve medications such as glycerin enemas lactulose. Although these interventions produce rapid effects, constipation episodes occur frequently in diabetic patients. Repeated administration of these drugs can easily lead to drug dependence and trigger anxiety. Traditional Chinese medicine holds that the spleen governs transportation and transformation, serving as the source of qi and blood production and the pivot of ascending and descending of qi movement. Moreover, spleen failing in transportation and transformation occupies a central position throughout the pathogenesis of diabetic constipation. This paper systematically reviews the theoretical origins and etiology and pathogenesis of treating diabetic constipation from the perspective of the spleen, summarizes the therapeutic systems including invigorating the spleen and supplementing qi, promoting qi movement to relieve stagnation, and moistening the intestines to unblock the bowels, and synthesizes the progress in related clinical applications of combined internal traditional Chinese medicine therapy with characteristic external treatments. By providing a systematic review of treating diabetic constipation from the perspective of the spleen, this paper aims to offer a theoretical basis and guidance for the clinical treatment of type 2 diabetic constipation.