【摘要】 糖尿病是慢性血糖异常升高的内分泌疾病，中医将其归于“消渴”的范畴。西医治疗此病多通过降糖、营养神经、改善循环等方法。中医治疗此病更具稳定性，很多中药有双向调节血糖的作用。王立琴教授经过近50年的临床实践，总结出消渴的病机为疾病初起五志过极，内生火热，热灼津液，致热盛阴伤；嗜食辛凉肥甘之物，积凉生湿，食辛化热，伤及脾胃，致脾胃运化失职；更生湿热，交搏阻于中焦，湿热蕴结，火热之邪伤津耗气；津气同源，气随津脱则气虚更甚，日久伤津耗气，故气阴两虚。糖毒内停，脾失于运化，上凌心肺，中损脾胃，下耗精气，伤及三焦，久致阴阳衰败。治疗上采取分期论治。疾病初期，一以热盛阴伤即热盛证候为主，阴伤夹瘀，治宜清解肺胃，直折火热，存阴生津，滋阴活血，予白虎汤加减；二为湿热蕴结，阴伤兼有瘀血，治宜清热利湿，健脾运胃，滋阴活血，予葛根芩连汤加减。疾病中期，气阴两虚，瘀热留滞，治宜益气养阴、清热活血化瘀，予自拟益气养阴方。疾病晚期，阴阳两虚，以阳虚证候为主，兼有阴虚瘀阻，治以温阳滋阴，培本固肾，活血祛瘀，兼清余热，予自拟补肾固肾方。王教授强调活血化瘀要贯穿于糖尿病治疗的不同时期，以整体调节。更多还原

【Abstract】 Diabetes is an endocrine disease characterized by chronic abnormal elevation of blood glucose. In traditional Chinese medicine, this disease is classified under the category of Xiaoke disease(消渴病). Western medicine mainly focuses on symptomatic treatment such as lowering blood glucose, nourishing nerves and improving circulation, while traditional Chinese medicine is more stable for the regulation of Xiaoke disease, and many Chinese medicines have bidirectional regulatory effects, as well as the regulation of blood glucose. After nearly 50 years of clinical practice, Professor WANG Liqin summarizes the pathogenesis of diabetes as follows: at the onset of the disease, excessive emotions lead to internal heat, which burns body fluids, resulting in excessive heat and damage to Yin; excessive consumption of spicy, cold, sweet, and fatty foods leads to accumulation of cold and dampness, and the consumption of spicy foods turns into heat, which in turn damages the spleen and stomach, causing them to lose their function; furthermore, damp-heat is generated, obstructing the middle energizer, resulting in damp-heat accumulation, and the evil of fire-heat damages body fluids and consumes Qi(气); body fluids and Qi originate from the same source, and as Qi is lost with body fluids, Qi deficiency becomes more severe, which leads to damage to body fluids and Qi, resulting in deficiency of both Qi and Yin(阴). Sugar toxins accumulate internally, causing the spleen to lose its function in digestion and transformation, affecting the heart and lungs in the upper body, damaging the spleen and stomach in the middle body, and consuming essence and Qi in the lower body, ultimately damaging the three energizers and leading to the decline of Yin and Yang(阳). The treatment adopts a staged approach. For the initial symptoms mainly characterized by the heat excess syndrome, it is advisable to clear the lungs and stomach, store Yin and produce fluids, nourish Yin and promote blood circulation in the treatment. It is recommended to use the modified Baihu decoction(白 虎 汤). For the initial symptoms characterized by damp-heat accumulation syndrome, which includes Yin injury and blood stasis, the treatment should focus on clearing heat and dampness, strengthening the spleen and stomach, nourishing Yin and promoting blood circulation. It is recommended to use the Gegen Qinlian decoction(葛根芩连汤). For the mid-term symptoms of Qi and Yin injuries, as well as stasis and heat retention, the treatment should focus on nourishing Qi and Yin, clearing heat, promoting blood circulation, and removing blood stasis. Self formulated prescription for nourishing Qi and Yin can be used. For late stage symptoms characterized by Yin and Yang deficiency, the treatment includes warming Yang and nourishing Yin, nourishing the body and strengthening the kidneys, promoting blood circulation and removing blood stasis, and clearing excess heat. Self formulated prescription for tonifying and strengthening kidney can be used. Professor WANG stresses that promoting blood circulation and removing blood stasis should run through different periods of the treatment, and the overall adjustment effect is good.更多还原