韩旭 倪青

摘要 糖尿病是由于多种病因引起的内分泌代谢性病，属于中医“消渴”范畴。大柴胡汤出自《伤寒杂病论》，为表里双解之剂。现代研究表明，大柴胡汤临床应用其可治疗糖尿病等代谢异常疾病，并可取得显著的疗效。文章介绍了倪青教授运用大柴胡汤的典型医案。倪教授治疗糖尿病，不拘泥于传统的“三消辨证”诊疗模式，病证结合，辨证论治，同时调摄患者饮食生活，取得确切疗效。以期为临床应用经方治疗糖尿病提供了思路。

关键词 糖尿病;大柴胡汤;经方

New Usage of Dachaihu Decoction in the Treatment of Diabetes

HAN Xu1，NI Qing2

（1 The Third Affiliated Hospital of Qiqihar Medical University，Qiqihar 161099，China; 2 Guang′anmen

Hospital，China Academy of Chinese Medical Sciences，Beijing 100053，China）

Abstract Diabetes is an endocrine and metabolic disease caused by a variety of causes，which belongs to the category of “consumptive thirst” in traditional Chinese medicine（TCM）.Coming from Treatise on Cold Pathogenic and Miscellaneous Diseases，Dachaihu Decoction is a formula for relieving both superficial and internal disorders.Modern research shows that clinical application of Dachaihu Decoction can treat metabolic diseases such as diabetes，and can achieve significant curative effects.In addition，this paper introduces Professor NI Qing′s typical medical case of using Dachaihu Decoction.Mr.NI′s treatment of diabetes is not limited to the traditional “three elimination syndrome differentiation” diagnosis and treatment model，but is a combination of disease and syndrome based on syndrome differentiation，and at the same time，adjusts the patient′s diet and obtains the exact effect，which can hopefully provide ideas for the clinical application of TCM in the treatment of diabetes.

Keywords Diabetes mellitus; Dachaihu Decoction; Classic prescriptions

中圖分类号：R255.4文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.05.011

糖尿病是由于多种病因引起以慢性高血糖和脂代谢异常为特征的内分泌代谢病。中医称之为“消渴”。其典型临床表现为多尿、多饮、多食及消瘦。从六经辨证来讲，三消症状明显，又伴随着身热汗出、大便秘结，病在肌肉、胃肠，可归属于阳明病;病在表、在皮毛者，如合并一些皮肤、肺部或泌尿系感染，可归属于太阳病[1]。按照《伤寒论》方证理论，太阳、阳明合病属表里同病范畴，而经方大柴胡汤为表里双解之剂，治疗此类疾病具有良好疗效。消渴病中太阳与阳明合病者，运用六经辨证，可以简驭繁，用于指导临床治疗。

1 糖尿病源流及探讨

糖尿病是一种复杂的内分泌代谢性疾病，可归中医“消渴”范畴。消渴之名首见于《素问·奇病论》[2]，其中提到：“此肥美之所发也，此人必数食甘美而多肥也。肥者，令人内热，甘者令人中满，故其气上溢，转为消渴。”东汉·张仲景著有专著《消渴》专篇，始以“消渴”作为病证提出。……