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黎柳, 周彤艺, 刘秀, 刘熠, 田娜, 邹俊驹, 向琴, 喻嵘.基于“脾肝散精，归于权衡”探讨2型糖尿病的辨治[J].湖南中医药大学学报英文版,2025,45(5):956-961.[Click to copy
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| 基于“脾肝散精，归于权衡”探讨2型糖尿病的辨治 |
| 黎柳,周彤艺,刘秀,刘熠,田娜,邹俊驹,向琴,喻嵘 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| “脾肝散精，归于权衡”理论出自《黄帝内经》，旨在恢复“脾肝散精”功能，且核心与现代肠道菌群稳态密切相关。而2型糖尿病病机中“脾肝散精”障碍和肠道菌群紊乱是关键病理基础，且与“肠-脾-肝”轴功能失调构成关键病理环节。因此，可将“脾肝散精，归于权衡”理论运用于2型糖尿病辨证治疗。基于此，治疗上发挥中医“异病同治”特点，提出运用建中类方、半夏泻心汤等补运脾胃、助脾散精，当归芍药散、柴胡桂枝干姜汤等肝脾同治、助肝散精，达到恢复肠道菌群稳态、血糖稳定和控制疾病等“归于权衡”之势。 |
| 关键词: 2型糖尿病 脾肝散精 归于权衡 肠道菌群 肝脾同治 医案 |
| DOI：10.3969/j.issn.1674-070X.2025.05.026 |
| Received:September 17, 2024 |
| 基金项目:国家自然科学基金项目（U21A20411，82074400）；湖南省自然科学基金项目（2024JJ1007，2024JJ5303）；湖南省中医药科研课题项目（B2024003）；湖南中医药大学学科建设“揭榜挂帅”项目（22JBZ002）；湖南省研究生科研创新项目（CX20230787）。 |
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| Pattern identification and treatment for type 2 diabetes mellitus based on "spleen and liver disseminating essence to achieve harmonious balance" |
| LI Liu, ZHOU Tongyi, LIU Xiu, LIU Yi, TIAN Na, ZOU Junju, XIANG Qin, YU Rong |
| (School of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Originating from the Huang Di Nei Jing (Huangdi's Classic of Medicine), the theory of "spleen and liver disseminating essence to achieve harmonious balance" aims to restore the function of "spleen and liver disseminating essence." Its core mechanism is closely linked to the homeostasis of the gut microbiota in modern medicine. In the pathogenesis of type 2 diabetes mellitus (T2DM), dysfunctional "spleen and liver disseminating essence" and gut microbiota dysbiosis serve as pivotal pathological foundations, forming a critical pathological nexus with the "gut-spleen-liver" axis dysfunction. Therefore, the theory of "spleen and liver disseminating essence to achieve harmonious balance" can be applied to the pattern identification and treatment of T2DM. Based on this, by leveraging the characteristic of "same treatment for different diseases" in Chinese medicine, this paper has proposed the use of Jianzhong-type formulas, Banxia Xiexin Decoction and other formulas to tonify and regulate the spleen and stomach, thereby assisting the spleen in disseminating essence. Additionally, formulas such as Danggui Shaoyao Powder and Chaihu Guizhi Ganjiang Decoction are employed to simultaneously treat the liver and spleen, facilitating the liver's role in disseminating essence. These measures aim to restore the homeostasis of the gut microbiota, stabilize blood glucose levels, and control the disease progression, ultimately achieving a state of "harmonious balance" as described in the theory. |
| Key words: type 2 diabetes mellitus spleen and liver disseminating essence to achieve harmonious balance gut microbiota simultaneously treating the liver and spleen medical record |
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