林湘东，向茗，陈新宇

    〔摘要〕 基于脏腑整体观，本文从脾胃、肝胆、肾命门及心肺4部分详细论述糖尿病的病因病机和治法方药，提出膏浊困脾、肝失疏泄、肾失气化、心肺失调导致“脾不散精”是糖尿病发病的关键因素。临证将其分为膏浊困脾、中满内热、脾胃虚损、肝郁化火、肝郁脾虚、肝肾阴虚、胆郁痰扰、肾阴亏虚、肾阳亏虚、阴阳两虚、气阴两虚、痰瘀互结基本证侯，治以健脾和胃、开郁清热、疏肝理脾、清肝泻火、滋补肝肾、滋阴补阳、益氣养阴、化痰通络等法。

    〔关键词〕 糖尿病;脏腑辨证;健脾和胃;疏肝理脾;滋补肝肾;化痰通络

    〔中图分类号〕R255.4? ? ? ? 〔文献标志码〕B? ? ? ?〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.11.024

    Treating Diabetes Based on the Holistic View of Zang-fu Organs

    LIN Xiangdong1， XIANG Ming2， CHEN Xinyu1*

    (1. The First Affiliated Hospital of Hunan University of Chinese Medicine， Changsha， Hunan 410007， China; 2. Department of Diagnostics in Chinese Medcine， Hunan University of Chinese Medicine， Changsha， Hunan 410208， China)

    〔Abstract〕 Based on the holistic view of Zang-fu organs， this article elaborates the etiology， pathogenesis and prescription of diabetes from four parts： spleen and stomach， liver and gallbladder， kidney and Mingmen， heart and lungs. It is proposed that spleen impaired by Gaozhuo， failure of liver to convey and disperse， disfunction of kidney for activation of Qi and cardiopulmonary disorders leading to “spleen failing to disperse nutrients” are the key factors in the onset of diabetes. Clinical syndromes are divided into basic syndromes of spleen impaired by Gaozhuo ......