摘要
《伤寒杂病论》认为,消渴的发病机制为劳逸失度,伤及气血,致气虚生内热,阴津匮乏,阳亢、脾虚、瘀血、肝郁、肾亏是其重要发病机制之一。肺胃热盛型消渴,阴津不足为本,火邪燔灼为标,气虚为热耗之渐,病位在肺、胃两脏,采用白虎加人参汤治疗。肾元虚衰型消渴,病在下焦,病机为肾气虚衰,阴阳两虚,多为阴损及阳,采用肾气丸治疗。气虚水饮型消渴,病在下焦膀胱,病机为虚实夹杂,内伤兼外感,采用五苓散治疗。瘀血内热型消渴,病机为瘀血内停,蕴而化热伤津,虚实夹杂,采用抵当丸治疗。厥阴消渴,病机复杂多变,虚实互见,寒热错杂,采用乌梅丸治疗。肾亏痰郁型消渴,病机为肾水不足,兼有痰湿,虚中夹实,错综复杂,采用文蛤散治疗。
According to Treatise on Cold Damage and Miscellaneous Diseases,the pathogenesis of diabetes is uneven allocation of work and rest,which leads to the injury of qi and blood,the deficiency of qi generating internal heat,the deficiency of yin and fluid.The hyperactivity of yang,spleen deficiency,blood stasis,liver depression and kidney deficiency are important pathogeneses.For diabetes with excessive heat in the lung and stomach,the deficiency of yin and fluid is the primary cause,the burning fire pathogen is the secondary cause,and the deficiency of qi is the gradual change of heat consumption.The disease is located in the lung and stomach,so White Tiger Decoction plus Ginseng Decoction is often used.For diabetes with deficiency and decline of kidney,the disease is in lower energizer.The pathogenesis is kidney deficiency and yin-yang deficiency.It is mainly due to yin impairment affecting yang,so Kidney Qi Pill is often used.For diabetes with fluid retention,the disease in the lower energizer bladder,and the pathogenesis is deficiency and excess in complexity,intermingled internal injury and exogenous pathogens,so Five Substances Powder with Poria is often used.For diabetes with blood stasis and internal heat,the pathogenesis is accumulated blood stasis transforming into heat and hurting fluid,deficiency and excess in complexity,so Resistance Pill is often used.For diabetes with reverting yin syndrome,the pathogenesis is complex and changeable,deficiency and excess in complexity,alternating chills and fever,so Mume Pill is often used.For diabetes with kidney deficiency and phlegm stagnation syndrome,the pathogenesis is kidney water deficiency,phlegm dampness,combined with excess,so Meretrix powder is often used.
作者
龙新胜
LONG Xin-sheng(No.83 Group Military Hospital of PLA,Xinxiang,Henan,China,453000)
出处
《河南中医》
2021年第3期325-327,共3页
Henan Traditional Chinese Medicine
基金
国家重点基础研究发展计划(973计划)项目(2005CB523501)
河南省科技攻关计划项目(192102310431)。
关键词
消渴
白虎加人参汤
肾气丸
五苓散
抵当丸
乌梅丸
文蛤散
《伤寒杂病论》
张仲景
diabetes
White Tiger Decoction plus Ginseng Decoction
Kidney Qi Pill
Five Substances Powder with Poria
Resistance Pill
Mume Pill
Meretrix Powder
Treatise on Cold Damage and Miscellaneous Diseases
Zhang Zhong-jing
