从罢极之本论治2型糖尿病

From the Extremely the Treatment of Type 2 Diabetes

摘要: 2型糖尿病属于中医学“消渴病”范畴。肝为罢极之本，具有主疏泄、主藏血的生理特性，为气机升降出入的枢纽，是调和人体气血的中转轴，是疏调情志活动的将军之官。大多数人认为糖尿病的病因与禀赋不足、饮食不节、情志失调等因素息息相关，病位主要在肺、胃、肾。而笔者认为消渴病主要因素为情志内伤、肝失疏泄，发病与肝关系密切，其中情志失调又是肝失疏泄的核心，肝胆疏泄失常是本病的使动因素，肝不藏血则是糖尿病发病的主要病机。本病的西医治疗有医学营养疗法、运动疗法、血糖监测、口服药物疗法及胰岛素等对症治疗，单纯使用西药虽降糖效果好，但对某些并发症的改善并不明显。因此本文主要从肝论治消渴病的机制进行探析，提出以疏肝、清肝、调肝为治疗法则，以期发挥中医特色，提高临床疗效。

Abstract: Type 2 diabetes belongs to the category of “diabetes” in traditional Chinese medicine. Liver is the origin of baji, with the physiological characteristics of main drainage and main blood storage. It is the hub of qi machine, the central axis of harmonizing human qi and blood, and the officer of the general in regulating emotional activities. Most people believe that the etiology of diabetes is closely related to factors such as insufficient endowment, diet and emotion, and the disease loca-tion is mainly in lung, stomach and kidney. The author believes that the main factors of diabetes are emotional internal injury and liver loss of catharsis, and the occurrence of diabetes is closely related to liver, among which emotional disorder is the core of liver loss of catharsis, liver and gallbladder disorder is the driving factor of the disease, and liver not storing blood is the main pathogenesis of diabetes. Western medicine treatment of the disease has medical nutrition therapy, exercise therapy, blood glucose monitoring, oral drug therapy and insulin and other symptomatic treatment, simple use of western medicine although hypoglycemic effect is good, but the improvement of some complications is not obvious. Therefore, this paper mainly discusses the mechanism of treating diabetes from the perspective of liver, and puts forward the treatment rules of regulating liver, clearing liver and regulating liver, in order to give play to the characteristics of traditional Chinese medicine, improve clinical efficacy.