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| 基于《丹溪心法》六郁理论分期辨治胰腺内外分泌共病 |
| Staged Diagnosis and Treatment of Pancreatic Exocrine-Endocrine Comorbidity Based on the Theory of Six Stagnations in Danxi Xinfa |
| 投稿时间：2026-10-09 修订日期：2026-10-09 |
| DOI： |
| 中文关键词: 六郁 胰腺内外分泌共病 分期辨治 胰源性糖尿病 越鞠丸 |
| 英文关键词: six stagnations pancreatic exocrine-endocrine comorbidity staged treatment pancreatogenic diabetes Yueju Wan |
| 基金项目:第七批北京市级中医药学术继承工作项目 |
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| 中文摘要: |
| 目的 基于丹溪心法六郁理论探讨胰腺内外分泌共病的病机演变与分期辨治方案。方法 梳理《黄帝内经》五郁、朱丹溪六郁及戴思恭“传化失常”学说源流,将胰腺外分泌与内分泌功能分别对应中焦之“传”与“化”,结合粪弹性蛋白酶-1(FE-1)、血糖、糖化血红蛋白(HbA1c)及影像学指标拟定分期。结果 急性发作期治以通腑泄热、行气开郁,方选清胰汤或大柴胡汤；缓解期早、中、后期分别予越鞠丸合平胃散行气消食化湿、越鞠丸合黄连温胆汤行气化痰清热、越鞠丸合六君子汤加活血之品健脾活血散瘀,并附验案1则。结论 六郁动态递进是外分泌损伤累及内分泌的核心病机,分期辨治可为本病早防早治、阻断病程进展提供参考,其客观指标阈值及与证候的对应关系尚待大样本前瞻性临床研究验证。 |
| 英文摘要: |
| Objective To explore the pathogenesis and staged treatment of pancreatic exocrine-endocrine comorbidity based on the six-stagnation theory of Danxi Xinfa. Methods The theoretical evolution from the five-stagnation theory in Huangdi Neijing to Zhu Danxi"s six stagnations and Dai Sigong"s “dysfunction of transmission-transformation” was reviewed, and pancreatic exocrine and endocrine functions were corresponded to “transmission” and “transformation” of the middle jiao, respectively. The staging scheme was formulated according to fecal elastase-1 (FE-1), blood glucose, glycated hemoglobin (HbA1c) and imaging findings. Results For the acute exacerbation phase, purging the fu-organs, clearing heat and moving qi are applied, with Qingyi Decoction or Dachaihu Decoction; for the early, middle and late stages of the remission phase, Yueju Wan combined with Pingwei Powder, Huanglian Wendan Decoction, or Liujunzi Decoction plus blood-activating herbs is used, respectively. One representative case is reported. Conclusion The dynamic progression of the six stagnations constitutes the core pathogenesis whereby exocrine injury extends to involve endocrine function. The staged treatment provides a reference for early prevention and treatment, while its cutoff values and correspondence with patterns await validation in large-sample prospective clinical studies. |
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