徐曼曼 韦妮娜 崔翰明

[摘要] 初发型2型糖尿病属于中医“消渴”范畴，其病因病机复杂多变，且无典型的临床表现，增加了认知的困难性。本文结合“虚气留滞”理论，对其病因病机特征进行分析，认为情志内伤、饮食不节及禀赋不足是其发病条件;诸气不足、脏腑亏虚是其发病基础;气滞、血瘀、痰浊、毒聚等病理产物是其发病环节;虚气与留滞相互影响，“虚”“滞”互为因果，形成螺旋式发展的病机模式，为糖尿病早期干预提供了新的思路，具有重要的临床指导意义。

[关键词] 初发型2型糖尿病;虚气留滞;病因病机;病理产物

[中图分类号] R255.4          [文献标识码] A          [文章编号] 1673-7210（2020）07（a）-0116-04

[Abstract] Newly onset type 2 diabetes belongs to the category of “thirst quenching” in traditional Chinese medicine. Its etiology and pathogenesis are complex and changeable， and there is no typical clinical manifestation， which increases our difficulty in understanding it. Based on the theory of “deficient-qi stagnation”， this article analyzes its etiology and pathogenesis characteristics， and conclusions are achieved that internal trauma， inadequate diet and inadequate endowment are its morbidity condition; insufficient qi and deficiency of viscera are the basis of its pathogenesis; pathological products such as qi stagnation， blood stasis， phlegm turbidity and poisonous aggregation are the pathogenesis; qi deficiency and stagnation interact with each other， and “deficiency” and “stagnation” are mutual causes and effects， forming a pathogenesis model of spiral development. It provides new ideas for early intervention of diabetes and has important clinical guidance significance.

[Key words] Newly onset type 2 diabetes; Deficient-qi stagnation; Etiology and pathogenesis; Pathological products

虛气留滞，也称为“虚气流滞”，即元气虚衰、气血津液等流动物质发生郁滞的病理变化[1]。在宋代杨士赢《仁斋直指方》“虚气留滞”理论的基础上，王永炎院士根据多年来的临床实践并结合中医理论所形成的新的中医病机观点，可用以阐释中医内科多种疾病的共同病理环节，如糖尿病、抑郁症、冠心病、癌症等[2]。近年来，由于人们生活方式的转变，糖尿病已成为第3位危害人类健康的慢性重大疾病。2008年的流行学数据显示，中国处于糖尿病前期的患者约有1.48亿[3]。而在2013年的一项数据显示，中国成年人糖尿病前期发病率大幅度增加，约占50.1%[4]。截止到2045年，全球将会有近7亿糖尿病患者[5-6]，因此初发型2型糖尿病患者将呈爆发性增长。中医认为，糖尿病属于“消渴”“消瘅”“肺消”“膈消”等范畴，中医是从整体、人体的大系统来进一步认识初发型2型糖尿病，在脏腑功能亏虚的基础上，气血津精疏布失常，致气滞、血瘀、痰浊、毒聚等病理产物聚集，留滞而为该病。……