仝小林院士运用“态靶辨证”理论治疗糖尿病重度胃瘫经验

张宇昕; 尹瑞阳; 张艳娇; 苗润宇; 方心怡; 田佳星

doi:10.3969/j.issn.1671-038X.2024.11.14

仝小林院士运用“态靶辨证”理论治疗糖尿病重度胃瘫经验

- 1.
  中国中医科学院广安门医院代谢病研究所(北京，100053)
- 2.
  北京中医药大学
基金项目:
中国中医科学院广安门医院临床医学研究中心建设专项(No：2022LYJSZX12)；中国中医科学院优秀青年科技人才培养专项(No：ZZ13-YQ-026)

详细信息

通讯作者: 田佳星，E-mail：tina_yai@126.com

中图分类号: R256.3

收稿日期: 2023-11-11

刊出日期: 2024-11-15

Experience of Academician TONG Xiaolin in treating severe diabetic gastroparesis by using "differentiation and treatment based on state-target"

- 1.
  Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- 2.
  Beijing University of Chinese Medicine

More Information

Corresponding author: TIAN Jiaxing, E-mail: tina_yai@126.com

Received Date: 11 November 2023

Publish Date: 15 November 2024

摘要

摘要: 糖尿病胃瘫是一种常见的糖尿病患者胃肠道并发症，临床上重症患者较多，但药物治疗存在一定的局限性。本文总结仝小林院士运用“态靶辨证”理论治疗糖尿病重度胃瘫的临证经验，仝小林院士认为其关键病机在于脾胃虚寒，以“阳虚”与“气机失调”为着眼点，主张“温阳益气”为治疗总则。以附子理中汤作为调节糖尿病胃瘫调“寒态”的代表方，有温阳散寒、益气健脾之效，方中附子、干姜为症靶要药。临床上运用附子理中汤随症加减，为糖尿病重度胃瘫的治疗提供临床指导依据。
- 糖尿病重度胃瘫 /
- 态靶辨证 /
- 温阳益气 /
- 验案总结 /
- 仝小林
Abstract: Diabetic gastroparesis is a common gastrointestinal complication in diabetic patients. There are many severe patients in clinical practice, but there are some limitations in drug treatment. This paper summarizes Academician TONG Xiaolin's clinical experience in treating severe diabetic gastroparesis with the theory of "differentiation and treatment based on state-target" and holds that the key pathogenesis lies in the deficiency of spleen and stomach, and that "warming Yang and benefiting Qi" should be the general treatment principle. Fuzi Lizhong decoction is a representative prescription to regulate the "cold state" of severe diabetic gastroparesis. It has the effect of warming Yang and dispelling cold, supplementing Qi and strengthening spleen. The clinical application of Fuzi Lizhong decoction with the increase and decrease of the disease, to provide clinical guidance for severe diabetic gastroparesis.
- diabetic severe gastroparesis /
- differentiation and treatment based on state-target /
- warming Yang and benefiting Qi /
- experiential case summary /
- TONG Xiaolin

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参考文献(18)

[1]	Ahmed MSO, Forde H, Smith D. Diabetic gastroparesis: clinical features, diagnosis and management[J]. Ir J Med Sci, 2023, 192(4): 1687-1694. doi: 10.1007/s11845-022-03191-8
[2]	Camilleri M. Gastrointestinal motility disorders in neurologic disease[J]. J Clin Invest, 2021, 131(4): e143771. doi: 10.1172/JCI143771
[3]	Bharucha AE, Kudva YC, Prichard DO. Diabetic Gastroparesis[J]. Endocrine Rev, 2019, 40(5): 1318-1352. doi: 10.1210/er.2018-00161
[4]	王斌祥, 蔡晓微, 陈瑞芹. 消痞方联合枸橼酸莫沙必利分散片治疗糖尿病胃轻瘫临床研究[J]. 新中医, 2022, 54(21): 96-100.
[5]	仝小林. 态靶医学——中医未来发展之路[J]. 中国中西医结合杂志, 2021, 41(1): 16-18.
[6]	张莉莉, 王蕾, 周毅徳, 等. 仝小林"慢病十态"之调态方略简析[J]. 中医杂志, 2021, 62(11): 934-938, 942.
[7]	段丽云, 顾成娟. 干姜、吴茱萸、肉豆蔻治疗2型糖尿病胃轻瘫(脾阳虚型)经验——仝小林三味小方撷萃[J]. 吉林中医药, 2020, 40(11): 1411-1413.
[8]	唐程, 高泽正. 仝小林院士治疗糖尿病重度胃瘫验案1例[J]. 吉林中医药, 2022, 42(8): 955-957.
[9]	白琳, 刘艳霞, 计烨. 糖尿病胃轻瘫应用加味附子理中汤治疗的效果分析[J]. 糖尿病新世界, 2022, 25(22): 171-173, 177.
[10]	张宁, 罗石任. 附子理中丸联合双歧杆菌四联活菌片治疗2型糖尿病性腹泻(脾肾阳虚证)的效果及对胃肠道微生态、炎症指标的影响[J]. 临床医学研究与实践, 2023, 8(3): 125-127.
[11]	杨霞, 吉红玉, 邸莎, 等. 附子临床应用及其用量[J]. 吉林中医药, 2019, 39(9): 1154-1157.
[12]	张君合, 潘赐明, 荆玉斐. 《伤寒论》干姜、附子药对证治规律与量效关系[J]. 西南医科大学学报, 2022, 45(2): 146-150.
[13]	董艳, 姚魁武, 王阶. 辨姜及其炮制品药理和临床运用特点[J]. 中国中药杂志, 2018, 43(10): 2020-2024.
[14]	张璐, 王建, 赵艳玲. 附子与干姜配伍的药理学研究进展[J]. 中国医院用药评价与分析, 2018, 18(11): 1441-1443, 1446.
[15]	Liu J, Tan Y, Ao H, et al. Aqueous extracts of Aconite promote thermogenesis in rats with hypothermia via regulating gut microbiota and bile acid metabolism[J]. Chin Med, 2021, 16(1): 29.
[16]	Kuretu A, Arineitwe C, Mothibe M, et al. Drug-induced mitochondrial toxicity: Risks of developing glucose handling impairments[J]. Front Endocrinol(Lausanne), 2023, 14: 1123928.
[17]	徐桐, 丛竹凤, 贺梦媛, 等. 干姜的研究进展及质量标志物分析[J]. 山东中医杂志, 2022, 41(5): 569-575.
[18]	付加雷. 姜油酮的现代药理作用研究进展[J]. 环球中医药, 2022, 15(9): 1736-1741.