本文基于糖尿病及抑郁症治疗的临床实践,从理论上探讨了糖尿病、抑郁症及糖尿病并发抑郁症各自的病因病机、治则治法,认为糖尿病病机在于五脏同病,肝脾肾三脏为主,正虚与邪实互见;而在糖尿病并发抑郁症的病机中,其病变脏腑已延及于心、肝、脾、肾,病情进一步加重。肝脾肾同调理论可贯穿糖尿病及其并发症的始终,据此可把握糖尿病的主要矛盾,兼顾抑郁症的治疗,并提出了五步辨证法在糖尿病诊疗中的具体应用,在临床实施中有一定的指导作用。
Based on the clinical experience of both diabetes and depressive disorders,this paper explored the pathogenesis and therapeutic principles of diabetes and depressive disorders from theoretical perspective. The researchers found out that diabetic pathogenesis was associated with the five internal organs,but more related to the liver,the spleen and the kidney,characterized by both deficiency and excess. For diabetic and depression symptoms,the pathogenesis manifested in the heart,the liver,the spleen and the kidney,but with severer symptoms. The research concluded that the principle of regulating both the liver and the spleen could be applied in the treatment of diabetes and its complications,thus the main symptoms of diabetes can be highlighted and the symptoms of depression can be taken into consideration at the same time. This paper also proposed a five-step diagnostic and treatment method in guiding the concrete clinical practice.