中华中医药杂志(原中国医药学报)2023年2月第38卷第2期CJTCMP,February2023,Vol.38,No.2•493•·仁心雕龙·通信作者：袁华，湖南省长沙市雨花区韶山中路95号湖南中医药大学第一附属医院，邮编：410007，电话：0731-89669137E-mail：1796547997@qq.com从谷精运化视角构建糖尿病中医辨治体系袁华（湖南中医药大学第一附属医院，长沙410007）摘要：文章全新构建了糖尿病中医辨治体系：认为糖尿病以谷精溢脉为特征，应属中医“谷溢”范畴，其病位在血脉与脾胃。核心病机为运化失司，谷精溢脉；热伤气津，发为消渴；血脉受损，周身并病。辨治要点为辨病机、辨分期、辨年龄和辨缓急。总治则为加强教育、消谷降糖，总治法为改善生活方式和药物降糖。临床宜按脾瘅期（无症状高血糖期）、消渴期（有症状高血糖期）、消瘅期（慢性并发症期）和极期（急性并发症期）分期辨治。本辨治体系可实现糖尿病中西医理互通。关键词：糖尿病；中医；谷溢；脾瘅；消渴；消瘅；谷精；中西医结合ConstructiononthesystemofChinesemedicinesyndromedifferentiationandtreatmentofdiabetesfromtheperspectiveofgrainessencetransportationYUANHua(TheFirstAffiliatedHospital,HunanUniversityofChineseMedicine,Changsha410007,China)Abstract:ThispaperestablishedanewsystemofsyndromedifferentiationandtreatmentofdiabetesinChinesemedicine:Itisconsideredthatdiabetesischaracterizedbytheoverflowofgrainessencewhichbelongstothecategoryof‘grainoverflow’inChinesemedicine,anditslocationshouldbeinthebloodandspleenandstomach.Thecorepathogenesisisthelossoftherulesfortransportation,grainessenceoverflowvein;heatinjuryqiandbodyfluid,progresstoconsumptivethirst;blooddamage,sickallover.Themainpointsofdifferentiationandtreatmentaredifferentiationofpathogenesis,stage,ageandurgency.Thegeneraltreatmentistostrengtheneducation,digestthegrainandhypoglycemic,thegeneraltreatmentmethodistoimprovethelifestyleandreducethebloodsugarwithmedicine.Theclinicaldifferentiationandtreatmentshouldbedividedintofourstages:theperiodofspleendamage(asymptomatichyperglycemia),theperiodofconsumptivethirst(symptomatichyperglycemia),theperiodofconsumptivedisease(chroniccomplication)andtheperiodofextreme(acutecomplication).Thissyste...
