糖尿病性胃轻瘫是糖尿病常见和严重的并发症之一,仝小林教授通过潜心研究经典,并结合多年临床经验,认为糖尿病胃轻瘫的不同分期所表现的特点及病情的轻重程度不同,治疗重点亦不同。急性期将消除呕吐、胃胀等在内的主症作为主要方向来遣方用药;待病情缓解后,根据体质及主证、兼证等确定患者的中医证型,常见中医辨证分型为:①中焦壅滞,寒热错杂;②中焦虚寒,脾肾阳衰;③脾胃虚弱,痰湿阻滞;并认为中焦虚寒是糖尿病胃轻瘫中后期的最常见证型,以附子理中汤为主方治疗;同时结合患者的血糖状况进行治疗,临证紧扣症-证-病结合的辨治思路,取得良好疗效。
Diabetic gastroparesis(DGP) is one of the common and serious complications of diabetes. According to the study of ancient medical records and clinical experience, professor TONG deems that the treatment priority varies as the expression in dif erent stages and the extent of DGP. In acute phase, treatment is given priority to elimination of vomiting and stomach bloated. After disease remission, the type of syndrome is determined according to the patients' corporeity, principal syndrome and secondary symptom. The common TCM syndromes of DGP are types of ①stasis of middle jiao and cold and heat interwoven, ②deficiency-cold in middle-jiao and deficiency of the spleen-yang and kidney-yang, ③deficiency of the spleen and stomach and stagnation of phlegm-dampness. Professor TONG also regards that the type of deficiency-cold in middle-jiao is the most common syndrome in DGP in middle and later phase, and treats it with Fuzi Lizhong Decoction. In order to achieve good curative effect, in the treatment of DGP, the patients' blood sugars should be taken into consideration, and must be closely combined with the thought of combination of disease, syndrome and symptom.