张玉琴教授治疗糖尿病肠病经验
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摘要
糖尿病肠病是糖尿病诸多慢性并发症之一,其发病机制还没有完全明确,属中医学"消渴""泄泻"范畴,恩师张玉琴教授认为糖尿病肠病的病机多为脾虚湿盛和脾肾阳虚。消渴日久,正气虚衰,脾胃羸弱,脾胃升清降浊混乱,或日久迁绵不愈,气阴两伤,阴损及阳,脾气亏虚而运化水湿无力,脾失健运则水谷精微布散失司,水谷滞于肠,泌清别浊无力,混杂而下并发泄泻。本文在查阅及研究大量文献和资料的基础上,对张玉琴教授治疗糖尿病肠病的经验和学术思想进行了初步总结,以期为临床提供更有价值的指导。
Diabetic enteropathy is a common chronic complication of diabetes, the pathogenesis of the disease has not been completely clarified. Diabetic enteropathy belongs to the category of "eliminating thirst" and "diarrhea" in traditional Chinese medicine. The teacher thinks that the pathogenesis of diabetic enteropathy is spleen deficiency dampness and spleen and kidney yang deficiency., diabetes for long time, deficiency of vial qi, weakness of the spleen and the stomach, the clear qi of the spleen can not rise but drop, the turbid gas of the stomach is rising instead of falling, unable to distinguish between the clear and the muddy,or after a long period of time, there is no cure, impairment of both qi and yin, yin deficiency affecting yang, deficiency of temper and weakness of transferring water and dampness, spleen disabling, water valley fine cloth scattered division, water valley lags in intestines, unable to distinguish turbidity, mixed down with diarrhea, on the basis of a great deal of literature and research, learn from the teacher, summing up the teacher's clinical experience in the treatment of diabetic bowel disease.
Diabetic enteropathy is a common chronic complication of diabetes, the pathogenesis of the disease has not been completely clarified. Diabetic enteropathy belongs to the category of "eliminating thirst" and "diarrhea" in traditional Chinese medicine. The teacher thinks that the pathogenesis of diabetic enteropathy is spleen deficiency dampness and spleen and kidney yang deficiency., diabetes for long time, deficiency of vial qi, weakness of the spleen and the stomach, the clear qi of the spleen can not rise but drop, the turbid gas of the stomach is rising instead of falling, unable to distinguish between the clear and the muddy,or after a long period of time, there is no cure, impairment of both qi and yin, yin deficiency affecting yang, deficiency of temper and weakness of transferring water and dampness, spleen disabling, water valley fine cloth scattered division, water valley lags in intestines, unable to distinguish turbidity, mixed down with diarrhea, on the basis of a great deal of literature and research, learn from the teacher, summing up the teacher's clinical experience in the treatment of diabetic bowel disease.
引文
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[8]王庆其.内经选读[M].北京:中国中医药出版社,2007:148.
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[11]刘文全,张琴.糖尿病胃轻瘫的中医药治疗进展[J].中国中医急症,2005,13(5):471-472.
[12]李宏斌,李月萍.参苓白术散加减治疗糖尿病肠病36例[J].临床和实验医学杂志,2006(11):1827.
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[14]黄帝内经素问[M].田代华整理.北京:人民卫生出版社,2005.
[15]张介宾.景岳全书[M].北京:人民卫生出版社,2007.
[2]刘荣莉.糖尿病肠病[J].实用全科医学,2005,3(6):488.
[3]陈兴田.糖尿病肠病的诊断和治疗[J].新医学,1992,23(3):123-124.
[4]李昌祁.糖尿病最新进展[M].北京:中国医药科技出版社,1993:43-50.
[5]富克非.张玉琴教授从脾肾论治糖尿病肠病[J].中国现代药物应用,2015,9(10):223.
[6]倪红梅.《内经》“泄泻”之探析及演绎[J].上海中医药杂志,2008,42(9):45.
[7]张博纶.从“脾失健运”认识糖尿病肠病病机[J].中医药临床杂志,2016,28(11):1532.
[8]王庆其.内经选读[M].北京:中国中医药出版社,2007:148.
[9]刘荣莉.糖尿病肠病[J].实用全科医学,2005,3(6):488.
[10]冯健文.理气健脾和胃治疗糖尿病胃轻瘫30例临床观察[J].辽宁中医杂志,2008,10(11):1688-1689.
[11]刘文全,张琴.糖尿病胃轻瘫的中医药治疗进展[J].中国中医急症,2005,13(5):471-472.
[12]李宏斌,李月萍.参苓白术散加减治疗糖尿病肠病36例[J].临床和实验医学杂志,2006(11):1827.
[13]徐小萍.糖尿病性腹泻辨治六法[J].江苏中医药,2002,23(12):4-5.
[14]黄帝内经素问[M].田代华整理.北京:人民卫生出版社,2005.
[15]张介宾.景岳全书[M].北京:人民卫生出版社,2007.