“动-定序贯范氏八法”纯中药缓解2型糖尿病合并多种代谢紊乱验案举隅
增强出版Fan's Eight Methods of Action-determination Sequence of Chinese Medicine for Alleviating Type 2 Diabetes Mellitus Combined with Various Metabolic Disorders
扫 描 看 全 文
1.广东省中医院内分泌科,广州 510120
2.广州中医药大学第二临床医学院,广州 510000
扫 描 看 全 文
范冠杰, 张园, 姚佳. “动-定序贯范氏八法”纯中药缓解2型糖尿病合并多种代谢紊乱验案举隅[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34753022&Fpath=home&index=0
FAN Guanjie, ZHANG Yuan, YAO Jia. Fan's Eight Methods of Action-determination Sequence of Chinese Medicine for Alleviating Type 2 Diabetes Mellitus Combined with Various Metabolic Disorders[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34753022&Fpath=home&index=0
范冠杰, 张园, 姚佳. “动-定序贯范氏八法”纯中药缓解2型糖尿病合并多种代谢紊乱验案举隅[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34753022&Fpath=home&index=0 DOI:
FAN Guanjie, ZHANG Yuan, YAO Jia. Fan's Eight Methods of Action-determination Sequence of Chinese Medicine for Alleviating Type 2 Diabetes Mellitus Combined with Various Metabolic Disorders[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34753022&Fpath=home&index=0 DOI:
病史摘要,2,罗某,男性,41岁,初诊时间为2021年1月12日,主诉:发现血糖升高1月余。患者自觉平素口干,1月前外院诊断为2型糖尿病、高尿酸血症,当时外院查随机血糖37.87 mmol/L,糖化血红蛋白10.1%,空腹C肽2.35 ng/mL,谷氨酸脱羧酶抗体(GADA)阴性,尿酸831 μmol/L,甘油三酯18.23 mmol/L。现使用门冬胰岛素30(早餐前24U,午餐前16U,晚餐前22U,皮下注射)联合二甲双胍缓释片(0.5 g,po,bid)控制血糖,近期空腹血糖8~10.2 mmol/L,餐后2 h血糖9.0~16.4 mmol/L。患者觉年纪轻轻患上糖尿病,且需终身用药,忧虑重重,故寻求中医治疗。症见:患者形体肥胖,口渴多饮,情志不畅,时有关节肿痛,小便黄,大便调,舌红,苔黄白腻,脉沉弦。查体:身高165 cm,体重90 kg,BMI 33.06 kg/m,2,。中医诊断 消渴(湿热瘀阻证)西医诊断 2型糖尿病;肥胖症;高尿酸血症;血脂异常干预措施 初诊,西药予二甲双胍缓释片0.5 g,口服,bid;中医治法为“清热利湿,活血化瘀”,中药处方如下:土茯苓30 g、土贝母10 g、百合50 g、车前草30 g、茵陈30 g、忍冬藤30 g、虎杖30 g、薏苡仁30 g、丹皮30 g、白术30 g、连翘30 g。共14剂,每日1剂。中药煎服法:中药于水滚后再煮50分钟,以3000 mL煲至2000 mL,每日代茶饮。范冠杰教授详细询问患者的症状及需求,查看以前的化验检查结果后,建议患者先停用所有胰岛素,单用二甲双胍缓释片口服降糖,注意控制饮食,加强运动,调畅情志;并告知患者目前胰岛功能可,通过生活方式干预及中药治疗,糖尿病临床治愈绝对有希望。疗效转归 患者第二诊开始停用降糖西药,继续纯中药治疗2型糖尿病4月余,诸症消失,舌红,苔薄黄,脉弦。2021年7月至今未服用降糖药及中药,平素空腹血糖4~6 mmol/L,餐后血糖6~7.6 mmol/L,2022年7月10日复查糖化血红蛋白5.2%,空腹胰岛素13.10 μIU/ml,空腹C肽3.08 ng/mL,血脂、尿酸均较前明显下降,改善多种代谢紊乱,达到2型糖尿病临床缓解。
Summary of case history Male patient named, Luo, 41 years old, his first visit was on January 12, 2021. Blood sugar has been elevated for more than 1 month as his chief complaint. The patient consciously had dry mouth, and as diagnosed as type 2 diabetes mellitus and hyperuricemia in another hospital 1 month ago. At that time, the random blood glucose was 37.87 mmol/L, the glycosylated hemoglobin was 10.1%, the fasting C-peptide was 2.35 ng/ml, Glutamate decarboxylase antibody (-), the uric acid was 831μmol/L, and the triglyceride was 18.23 mmol/L. He uses Insulin as part 30 (24U before breakfast, 16U before lunch, 22U before dinner) subcutaneous injection combined with metformin sustained-release tablets (0.5g, orallytwice a day) to control blood sugar at present. The patient felt that he was suffering from diabetes at a young age and needed lifelong medication. He was worried, so he sought Chinese medicine treatment. His present symptoms included obese body type, thirsty and drinking more, emotional disturbance, joint swelling and pain, yellow urine, loose stool, red tongue, yellow and greasy coating, heavy and slippery pulse. Physical examination: Height 165 cm, weight 90 kg, BMI 33.06 kg/m,2,.,TCM diagnosis, Diabetes (Damp-heat Stasis syndrome),Western medicine diagnosis, Type 2 diabetes; obesity; hyperuricemia; abnormal lipid metabolism,Therapeutic methods, as for the initial diagnosis, western medicine prescription included metformin sustained-release tablets 0.5 gorally, twice a day, Chinese medicine treatment method included the method of clearing heat and removing dampness, promoting blood circulation and removing blood stasis. Prescription of traditional Chinese medicine: 30 g of Tuckahoe, 10 g of Fritillaria, 50 g of Lily, 30 g of Plantain, 30 g of Yin Chen, 30 g of Honeysuckle, 30 g of Polygonum cuspidatum, 30 g of Coix Seed, 30 g of Paeonol, 30 g of Atractylodes, and 30 g of Forsythia. A total of 14 doses, 1 dose per day. Decoction method: boil the traditional Chinese medicine in water for 50 minutes, boil it with 3000 mL to 2000 mL, and drink it as tea every day. Professor Fan Guanjie inquired about the patient's symptoms and needs in detail. After checking the previous laboratory test results, he suggested that the patient stop all insulin medications first, and only take metformin sustained-release tablets orally to lower blood sugar. Furthermore, professor Fan instructed the patient to pay attention to diet, strengthen exercise, and emotions. The patient's current islet function is good, and through appropriate lifestyle intervention and traditional Chinese medicine treatment, there is absolutely hope for clinical cure of diabetes.,Clinical outcomes, the patient started to stop the hypoglycemic western medicine at the second visit, and continued to treat type 2 diabetes with pure Chinese medicine for more than 4 months. The symptoms disappeared, the tongue was red, the coating was thin and yellow, and the pulse was stringy. Since July 2021, he has not taken hypoglycemic drugs or traditional Chinese medicine, his normal fasting blood glucose is 4~6 mmol/L, and his postprandial blood glucose is 6~7.6 mmol/L. On July 10, 2022, his glycated hemoglobin was 5.2%, and his fasting insulin was 13.10 μIU/ml, fasting C-peptide 3.08 ng/ml, blood lipids and uric acid were significantly lower than before, various metabolic disorders have been improved and clinical remission of type 2 diabetes was achieved.
2型糖尿病动-定序贯范氏八法中医
type 2 diabetes mellitusFan's eight methods of Action-determination sequencetraditional Chinese medicine
邹大进,张征,纪立农.缓解2型糖尿病中国专家共识[J].中国糖尿病杂志,2021,29(9):641-652.
田梦源.动-定序贯范氏八法学术思想及DM用药规律的研究[D].广州:广州中医药大学,2020.
张鹏,张锦明,宋薇,等."动-定序贯范氏八法"治疗消渴病理论初步阐述[J]. 中国中医基础医学杂志,2012,18(10):1071-1072.
魏华,卢绮韵,黄皓月,等."动-定序贯范氏八法"辨治糖尿病学术思想研究[J]. 新中医,2011,43(07):6-7.
陈妍妍."动-定序贯范氏八法"辨证治疗新诊断2型糖尿病的临床研究[D].广州:广州中医药大学,2011.
0
浏览量
11
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构