《金匮要略》消渴病临床辨治探讨

Discussion on clinical pattern differentiation and treatment of Xiaoke disease in Synopsis of the Golden Chamber

关键词:  《金匮要略》  消渴病  病机  肾气丸

Key words:  Synopsis of the Golden Chamber  Xiaoke disease  pathomechanism  Shenqi Pill

摘要:

文章基于《金匮要略》脏腑经络理论，从消渴病篇第1、2条原文入手，深入探讨了消渴病的病机内涵，概括出消渴病以厥阴风火相煽为病因，虚劳营卫不足为发病基础，坚数相搏、肾气不足、气化不利为核心病机。强调肾气丸作为消渴病的治疗主方，以恢复肾的气化功能为消渴病的核心治法。后世在《金匮要略》基础上对消渴病理论进行了扩展，包括证候、病因、方药及预防养生法。文章强调了《金匮要略》对于消渴病的价值，对现代论治糖尿病具有重要临床意义。

Abstract:

Based on the theory of zang-fu organs and meridians in Synopsis of the Golden Chamber，the article begins with the original text of the first and second clauses in the chapter on Xiaoke disease（wasting-thirst disease） to delve into its pathomechanism. It summarizes that the etiology of Xiaoke disease lies in the agitation of wind and fire in the Jueyin，with the deficiency of nutrient（ying） and defense（wei） qi due to consumptive disease as its pathological basis. The core pathomechanism involves the struggle between hardness and rapidity，deficiency of kidney qi，and inhibited qi transformation. It emphasizes Shenqi Pill（Kidney Qi Pills） as the main formula for treating Xiaoke disease，with the core therapeutic strategy being the restoration of the kidney’s qi-transformation function. Later generations expanded the theory of Xiaoke disease on the basis of Synopsis of the Golden Chamber，including developments in syndromes，etiology，formulas and medicinals，as well as preventive and health-preserving methods. The article highlights the value of Synopsis of the Golden Chamber regarding Xiaoke disease，which holds significant clinical importance for the modern treatment of diabetes.