The name "thirst-quenching" was first seen in sui Zhen's ancient and modern records and prescriptions, but it has been left behind. Its content can be found in the recipe for relieving thirst and kidney. "The Secret Recipe of Wai Tai Xiao Zhong Xiaoxiao Shen Xiao Fang" said: "There are three types of diabetes recorded in ancient and modern times: one is thirst, excessive drinking, no urine count (note: if there is), fat is as sweet as bran, and both are (note: if so) diabetes; Second, eating more, not very thirsty, urinating less, as if there is oil, but also eliminating diseases; You can't drink too much water when you are thirsty, but your legs are swollen and your feet are thin first, and your yin is weak. If you count those who urinate, this is also kidney disease, especially avoiding housework. " The classification and symptoms of diabetes, or the syndrome of diabetes in name, that is, the syndrome of three consumptions in later generations, are generally derived from this.
According to the different disease location, pathogenesis and symptoms, diabetes is also called "Three Disappearing Syndrome", that is, diabetes belongs to lung dryness, stomach heat and kidney deficiency.
In addition, the name of diabetes was first found in Historical Records and Sima Xiangru's biography. Its cloud says: "(Sima) writes a book like a stutter and often suffers from diabetes." Disease, other versions or as "disease", "Han Sima Xiangru Biography" as "disease".
Tong Xiaolin, director of the Chinese Medicine Diabetes Department of China-Japan Friendship Hospital, believes that if urine sugar or "three more and one less" is used as the diagnosis basis, the condition of most diabetic patients will be delayed. Diabetes, whether in connotation or extension, is very different from diabetes. The main complications of diabetes, except the increase of blood sugar, fundus lesions, renal lesions, diabetic foot, etc., are all damage to tiny blood vessels. In Chinese medicine, small blood vessels are called veins and large blood vessels are called meridians. Therefore, the main damage of diabetes is reflected in veins, and its damage to cardiovascular and cerebrovascular diseases is mostly indirect, which is only one of the reasons for damaging blood vessels. Professor Tong Xiaolin believes that if Chinese medicine wants to name diabetes, it is more appropriate to call it "sugar collateral disease". The greatest significance of calling diabetes "sugar collateral disease" lies in paying attention to both "sugar" and "collateral disease". In this way, from the day diabetes is discovered, we should pay attention to the damage of the disease to the vein, and focus on preventing and treating the complications caused by the vein damage, so as to achieve "treatment if there is one, prevention if there is none".
The academic value of establishing diabetes syndrome has also been supported by scholars. For example, Nie believes that diabetes syndrome focuses on a driving force in human body, which is called internal driving force in modern psychosomatic medicine. That is, the body has a high decomposition impulse; The result of high decomposition is to quench thirst. Therefore, the treatment prescription for quenching thirst is often effective for diseases such as diabetes and hyperthyroidism. This is the value of Chinese medicine in solving diseases based on the changes of physical signs. Nie Wentao pointed out in the article "Taming blood sugar, not binding blood sugar": Chinese medicine emphasizes that changes in the human body must have a leading force to play a role. That is, who will implement the "decree". This analysis of the relationship between "virtue" and "position" is also discussed at the beginning of Yi Zhuan Ci Shang. According to this basic idea of traditional Chinese medicine, the human body is insensitive to insulin because of the improper order of insulin. So, who will carry out the "decree" at this time? This is glucagon. This shows that the cause of diabetes is not insufficient synthesis at all, but excessive consumption. Because glucagon promotes the decomposition of human substances, while insulin promotes the synthesis of human substances. Obviously, frequent hypoglycemia, relative hypoglycemia or incomplete local blood glucose supply may lead to increased glucagon secretion, which may lead to diabetes. So this kind of stimulation of blood sugar must be avoided. Therefore, Chinese medicine began to pay attention to protecting the valley from Huangdi Neijing. Nowadays, high carbohydrate has become a recognized healthy diet for diabetic patients.
brief introduction
From the clinical manifestations, diabetes in traditional medicine in China is basically the same as diabetes in modern medicine.
Diabetes is a disease characterized by excessive drinking, overeating, polyuria and emaciation caused by yin deficiency and dryness-heat and deficiency of five internal organs.
The disease is a common disease, and its incidence has increased in recent years. Traditional Chinese medicine has a good effect in improving symptoms, preventing complications and improving the quality of life of patients.
There are many descriptions of quenching thirst in ancient Chinese medicine books. The name of diabetes comes from Neijing. For example, Su Wen's Treatise on Strange Diseases said: "This person must eat sweet fat, the fat one will make people feel hot inside, and the sweet one will make people full, then the gas will overflow and turn to quench their thirst." There are about fourteen articles in Neijing, which respectively discuss the nomenclature, etiology, pathogenesis, symptoms, treatment principles and prognosis of diabetes.
According to the different pathogenesis and symptoms, there are three other names for quenching thirst: eliminating malnutrition, eliminating lung, eliminating diaphragm and eliminating thirst. In terms of etiology, Neijing thinks that deficiency of five internal organs, emotional imbalance and overeating are the causes of diabetes, and emphasizes the important role of physical factors in the pathogenesis of diabetes.
The main pathogenesis is gastrointestinal heat accumulation and consumption of body fluids. Synopsis of the Golden Chamber specializes in the diagnosis and treatment of diabetes, and there are effective prescriptions such as Baihu plus ginseng soup and Shenqi Pill, which have been highly praised by clinicians so far.
On the basis of Neijing and synopsis of golden chamber, the etiology, pathogenesis, clinical manifestations, complications and treatment of diabetes were supplemented and developed in later generations. The theory of diabetes syndrome advocates "first 1200 steps, then 1000 steps, and then eat it", and initially realizes the significance of physical therapy in treating diabetes. The complications of this disease are described, and it is considered that "the lesion is multiple gangrene". According to the ancient and modern records recorded in "The Secret of Outer Taiwan: Quenching Thirst and Eliminating Middle Gate", "People who are thirsty and drink more water, urinate more, and are as sweet as bran without fat are all diabetic." Li Langzhongyun, the ancestral temple, was quoted as saying, "Those who quench their thirst ... urinate until it is sweet every time." . Have a deeper understanding of the clinical characteristics of diabetes. "Three Treatments of Taiping Sheng Huifang" said: "The husband is suffering from three hardships, one is thirsty, the other is suffering from two pains, and the third is suffering from three kidneys". Clearly put forward the "three poles" theory.
Differentiation and treatment of diabetes mellitus
Etiology and pathogenesis
1. As early as the Spring and Autumn Period and the Warring States Period, people have realized that insufficient congenital endowment is an important internal cause of diabetes. "Five Changes of Lingshu" said: "Those who are weak in five internal organs are good at eliminating malnutrition", especially those with yin deficiency constitution are the most vulnerable.
2. Eating too much fat and sweet for a long time due to improper diet, the wine is mellow and strong, spicy and dry, which damages the spleen and stomach, leading to dereliction of duty in transporting and transforming the spleen and stomach, accumulating heat and damaging body fluids, eliminating grains and consuming body fluids, and quenching thirst. "Su Wen Bing Qi Lun" said: "This fat beauty is also caused by this. This person must eat sweet and fat. Fat people make people hot inside, sweet people make people full, and then they overflow and turn to quench their thirst. "
3. Long-term excessive mental stimulation of emotional disorders, such as depression and anger hurting the liver, stagnation of liver qi, or exhaustion and competitiveness. , leading to long-term stagnation of internal heat, burning lung, stomach, yin and body fluid and quenching thirst. As "Three Disappearances of Clinical Medical Records" said: "Depression and spontaneous combustion of internal fire are serious illnesses."
4. Excessive desire for work, excessive desire for work, kidney essence loss, endogenous deficiency in fire, fire will be exhausted by water, water will be dried by fire, and eventually lead to kidney deficiency, lung dryness, stomach heat and thirst. For example, "The Secret of Outer Taiwan: Eliminating thirst and eliminating middle warmer" says: "Excessive housework, exhaustion of kidney qi, lower energizer generating heat, kidney dryness, and kidney dryness causing thirst."
The pathogenesis of diabetes mainly lies in yin deficiency and fluid loss, excessive dryness and heat, yin deficiency as the foundation and dryness and heat as the standard. The two are mutually causal. The more yin deficiency, the more dryness and heat, and the more yin deficiency. The viscera of diabetes mainly lie in lung, stomach and kidney, especially kidney. Among the three dirties, although they may be biased, they often influence each other.
Lung governing qi is the source of water, and body fluid is used. When the lung is injured by dryness and heat, the body fluid can't be used and often drops. It is excreted with urine, so there are many times of urination; If your lungs are not filled with fluid, you will be thirsty and drink more water. As "Compendium of Medicine" said: "Cover the lung to store qi. If the lung is free from disease, qi can control the subtle body fluid, and those with subtle body fluid can collect bones and muscles, and the rest are qi." Lung disease, body fluid is not taken through the trachea, but also with subtle people. "
The stomach is the sea of water valley, responsible for decomposing Shui Gu, and the spleen is the foundation of the day after tomorrow, responsible for transporting and transforming body fluids for the stomach. Dry heat hurts the spleen and stomach, stomach fire is blazing, and spleen yin is insufficient, so you are thirsty, drink more, eat more and be hungry; If the spleen qi deficiency cannot be transferred to the refined valley, then Shui Gu will inject urine into the refined valley, so the urine tastes sweet; Shui Gu's delicate muscles can't nourish her, so her body is getting thinner and thinner.
Kidney is the innate foundation, and the essence is stored in Yuan Yin and Yuanyang. Deficiency of kidney yin leads to deficiency in fire; Burning the heart and lungs leads to polydipsia; Focus on the spleen and stomach, leading to the disappearance of stomach heat; The kidney lost its nutrition; When it is opened and closed, it loses its strength, so Shui Gu's subtle and direct diarrhea will be excreted with urine, so urine is sweet.
Although the lung, stomach and kidney are different, diabetes often affects each other. For example, lung dryness, body fluid damage, spleen and stomach can not be nourished, and kidney essence can not help. Excessive dryness and heat of the spleen and stomach can burn the upper lung fluid and damage the lower kidney yin; Deficiency of kidney yin leads to hyperactivity of fire due to yin deficiency, which will also burn lung and stomach, and finally lead to lung dryness, stomach heat and kidney deficiency, so it is often seen that the syndromes of "triple energizer" appear side by side.
For a long time, diabetes is prone to the following two diseases: first, yin deficiency affects yang, and yin and yang deficiency. Although quenching thirst is based on yin deficiency and marked by dryness and heat, due to the mutual root of yin and yang, yang produces yin for a long time. If the course of disease is long, yin will damage yang, which will lead to deficiency of both yin and yang. Among them, kidney-yang deficiency and spleen-yang deficiency are more common. Second, a long illness leads to numerous collaterals and blood stasis. Diabetes is a disease that involves many viscera, affects the normal operation of qi and blood, causes internal heat due to yin deficiency, consumes body fluids and causes blood stasis due to poor blood circulation. Blood stasis is one of the important pathogenesis of diabetes, and the occurrence of various complications of diabetes is closely related to blood stasis.
Shang Xiao (lung heat injuring body fluid)