〔摘要〕 糖尿病心肌病(diabetic cardiomyopathy， DCM)作为糖尿病患者心血管严重并发症之一，具有较高的发病率和病死率。心脏能量代谢紊乱被认为是DCM病变的关键因素，这与中医“气食少火”理论密切相关。少火的消长贯穿本病病程始终，机体内壮火与少火相争的动态过程构成了DCM的3个发展阶段：代偿期的壮火渐盛与少火耗损，失代偿期的壮火燔炽与痰瘀形成，衰竭期的少火衰微与神机涣散。本文基于“气食少火”理论，分析DCM的能量代谢变化，阐明其中医证候特点，并探讨通过纠正心肌异常能量代谢中断DCM疾病链条，延缓其临床进展，为临床治疗提供思路。

    〔关键词〕 糖尿病心肌病；气食少火；能量代谢；中医证候本质；代偿期；失代偿期；衰竭期

    〔中图分类号〕R255.4 〔文献标志码〕A 〔文章编号〕doi：10.3969/j.issn.1674-070X.2024.10.022

    Pathogenesis evolution and energy metabolism characteristics of diabetic cardiomyopathy from the theory of "qi is generated by moderate fire"

    ZHANG Yuheng1， LIU Jianhe1，2*

    1. The First Hospital of Hunan University of Chinese Medicine， Changsha， Hunan 410007， China;

    2. National Clinical Research Center for Chinese Medicine Cardiology， Changsha， Hunan 410007， China

    〔Abstract〕 Diabetic cardiomyopathy (DCM)， as one of the severe cardiovascular complications in diabetic patients， exhibits high incidence and mortality rates. Disturbed cardiac energy metabolism is considered a key factor in the pathogenesis of DCM， closely related to the theory of "qi is generated by moderate fire" in Chinese medicine. The waxing and waning of moderate fire permeates the entire course of the disease ......