基于阴虚燥热病机的糖尿病分期与中药应用

Staging of Diabetes and Application of Chinese Herbal Medicine Based on the Pathogenesis of Yin Deficiency and Dryness-Heat

摘要: 糖尿病是最常见的慢性代谢性疾病之一，以持续的血糖水平升高为特点，其最典型的症状是“三多一少”(多饮、多食、多尿、体重减少)，长期的高血糖水平会损伤心脏、肾脏、眼睛和神经等多个器官，导致严重的并发症，对患者的健康构成了重大威胁。现代医学认为，2型糖尿病的关键病理机制在于胰岛素抵抗和胰岛β细胞功能的障碍。目前常用的西药，如二甲双胍等，虽然能有效地把血糖调节为正常范围内，但也有可能带来低血糖、胃肠道反应等不良反应。中医将糖尿病名为“消渴病”、“胰瘅”，该文基于阴虚燥热病机将糖尿病分为四期：早期(燥热偏盛)、中期(阴虚燥热)、中后期(气阴两虚)、晚期(阴阳两虚)，结合现代药理学研究，阐述了各期代表中药治疗糖尿病的多靶点作用机制，这为临床上应用中药治疗糖尿病提供了思路和科学依据。

Abstract: Diabetes is one of the most common chronic metabolic diseases, characterized by persistently elevated blood glucose levels. Its most typical symptoms are polydipsia, polyphagia, polyuria, and weight loss. Long-term hyperglycemia can damage multiple organs, including the heart, kidneys, eyes, and nerves, leading to severe complications such as coronary heart disease, nephropathy, and vision loss, posing a significant threat to health. Modern medicine holds that the key pathological mechanisms of type 2 diabetes lie in insulin resistance and dysfunction of pancreatic islet β-cells. Currently used Western medications, such as metformin, although effective in regulating blood glucose within the normal range, may also cause adverse reactions such as hypoglycemia and gastrointestinal effects. In traditional Chinese medicine, diabetes is named “Xiao Ke disease” or “Yi Dan”. Based on the pathogenesis of yin deficiency and dryness-heat, this article divides diabetes into four stages: early stage (dryness-heat), middle stage (yin deficiency), middle-late stage (qi and yin deficiency), and late stage (yin and yang deficiency). Combined with modern pharmacological research, it elucidates the multi-target mechanisms of representative Chinese herbal medicines in treating diabetes at each stage, thereby providing ideas and a scientific basis for the clinical application of Chinese herbal medicine in diabetes treatment.