传统医学专家疑难病专家孙淑芝
孙淑芝(孙洋)教授简历出生于中医世家,荣获“世界传统医学杰出贡献奖”荣获“国际养生专家”称号国际传统交流医科大学博士学位菲律宾国家客座教授国家高级健康管理师中医康复理疗师国家高级养生按摩师中国针灸协会会员中国中医健康管理医学研究院资深研究员中国民间中医医药研究协会生命健康专业委员会委员自幼喜好岐黄,跟随父亲学习诊脉、中药、针灸等技术,擅长《药针疗法》、《整脊疗法》、用体针、面针、耳针、火针、埋线等、调理各种疑难杂症:如糖尿病、心脑血管疾病、颈椎病、腰脱、坐骨神经痛、关节炎、面瘫、中风、头痛、胃痛、以及更年期、肥胖、月经不调、痛经、乳腺肿块、子宫肌瘤、卵巢襄肿等有立竿见影的效果!在患者中有良好的口碑!
Professor Sun Shuzhi (Sun Yang), born in a family of traditional Chinese medicine, was awarded the "world traditional medicine outstanding contribution award" and the"international health care expert" title, doctor's degree of international traditional exchange Medical University, national visiting professor of Philippines, national senior health manager, rehabilitation physiotherapist of traditional Chinese medicine, national senior health massager, member of China Acupuncture Association, Research Institute of health management of traditional Chinese Medicine Deep researcher, member of the life and health professional committee of China Folk Medicine Research Association, likes Qihuang since childhood. He studies pulse diagnosis, traditional Chinese medicine, acupuncture and other technologies with his father. He is good at acupuncture therapy, chiropractic therapy, body acupuncture, face acupuncture, ear acupuncture, fire acupuncture, thread embedding, etc., and recuperates various difficult and miscellaneous diseases, such as diabetes, cardio cerebrovascular disease, cervical spondylosis, lumbar spondylolisthesis and sciatic spirit Menstrual pain, arthritis, facial paralysis, stroke, headache, stomachache, menopause, obesity, irregular menstruation, dysmenorrhea, breast mass, hysteromyoma, ovarian swelling and so on have immediate effect! Good reputation among patients!
消渴病症之我见
My Views on Diabetes
患者多饮,多食,多尿。中医谓之消渴病,西医称之为糖尿病,消渴病的三多症状,往往同时存在。但根据其表现程度上的轻重不同而有上,中,下三消之分:即肺燥胃热肾虚之别,通常以肺燥为主。多饮症状与较突出者,称之为上消;胃热为主,多食症较为突出者称之为中消;以肾虚为主多尿现象较为突出者称之为下消。主要部位:肺燥;脾虚(胃热);肾虚。本病以阴虚为本,燥热为标:两者互为因果。常因病程长短及病情轻重的不同,而阴虚和燥热之表现各有侧重,患者初始多以肺热为主,病较长者多以阴虚与燥热互见,日久则以阴虚为主,进而则由阴损及阳导致阴阳俱虚,由而易发生多种并发症,如肺痨,耳聋,目盲,中风,水肿痈疸,心脑病肾衰竭。导致那么多并发症的发生多以辨症不清或患者长时间的依赖降糖药所导致,如二甲双呱,胰岛素。有些人还说消渴病人不能吃主食即(面食),不吃糖类的食物,导致糖份的丢失和不平衡,引起代谢失调。人体需要各种营养成分,包括糖不能多也不能少。今日的医学只发明了对糖分的检查,却不明白各种营养的流失的真正原因。热能燥金耗血,大肠受刑,故令大便燥结<景岳全书>。大渴饮,随饮,随渴,以上使津液枯涸。古云其病在肺,而不知心,火阳明之火,多食善肌,不为肌肉,日加消瘦其病在脾胃;又谓之中消也,小便赤黄为淋为浊,如膏如脂,面黑耳焦,日渐其瘦病在肾,故又名肾消也。此三消者,古人悉认为火症,然有实火者,以邪热有余也;有虚火者,以真阴不足也。治消症而不辩虚实,则未有不误者矣。消渴病的发生小便泡沫多,如膏如脂,浓油导营养的流失,还有糖分的流失,致使人体经络闭阻不通。
Polydipsia, polyphagia and polyuria are symptomatic of the so-called emaciation-thirst disease in traditional Chinese medicine, which is called diabetes in western medicine. The three ploys of diabetes often exist at the same time. However, by degree of manifestation, it can be classified into upper, middle and lower emaciation, which is distinguished by lung dryness, gastric fever and kidney deficiency. Generally, lung dryness is dominated. Those with polydipsia dominated are attributed to upper emaciation; those with gastric fever and polyphagia dominated are attributed to middle emaciation; those with kidney deficiency and polyuria dominated are attributed to lower emaciation, the onset of which mainly are lung dryness, and spleen deficiency (gastric fever) with kidney deficiency. Yin deficiency is the root of the disease, while dryness-heat is the sign. They interact as both cause and effect. The manifestation of Yin-deficiency or dryness-heat may be dominated depending on the duration and severity of the disease. Most of the patients early were dominated by pulmonary fever, while prolonged patients mostly by coexisting Yin deficiency and dryness-heat. Prolonged disease is predominately associated with Yin deficiency. As such, Yin deficiency progressively affects Yang, eventually leading to deficiency of both, from which a variety of complications can easily occur, such as lung tuberculosis, deafness, blindness, stroke, edema and carbuncle, cardio-encephalopathy, and renal failure. The occurrence of so many complications is mostly caused by unclear differentiation of symptoms or long-term dependence on hypoglycemic drugs, such as melbine and insulin. There is a saying goes that patient with diabetes should not eat staple food (i.e. wheaten food) and sugar food, which leads to the loss and unbalance of sugar and thus metabolic disorders. The human body needs a variety of nutrients, including sugar the amount of which cannot be more or less in your body. Today's medicine only invented the examination of sugar in the body, but is not aware of the real cause of the loss of nutrients is that internal heat can dry up the essence and consume blood, resulting in damage to the large intestine, which makes the stool dry and thirsty, but it drinks with thirst and eventually dries up the body fluid (Complete Works of Zhang Jingyue). As an old saying, its illness lies in the lungs, but not in the heart. The fire of Yangming leads to polyphagia. When the disease is in the spleen and stomach, it is also called middle emaciation. Its urine is red-yellow and cloudy, like ointment and fat, and its face is black and ear burns. When the disease in the kidney, it is also known as kidney emaciation. For these three emaciations, the ancients believed that it is fire disease. People with excess fire will cause excessive evil heat; while people with deficiency fire, will cause insufficient true yin. If the treatment of diabetes does not distinguish between excess fire and deficiency fire in the body, it will cause misdiagnosis of the disease. Diabetes can make urination foamed and greasy, resulting in loss of nutrients and sugar, and eventually obstruction of human meridians.
人体为小天地,宇宙为大的天地,人体的作用与天地的变化是相同的,例如:外面天气很热,流汗太多,盐分流失,喝杯盐水补充盐分,口渴喝杯糖水,补充糖分,如土之得雨水滋润,糖(甘味)——甘味入脾。脾属土,土能生长养万物,土生金,土润而金旺以生水。天气下降为雨水,水气上升为云雾。天气下降为雨水。水气上升为云雾。天气下降为雨水,能降气温。脾主肌肉。土旺则饮食甘关而肌肉强,小孩喜欢吃糖之主阴。乃为供给迅速生长发育的肌肉,甘津之气布溢。全身得以润泽,肌肉强能使皮肤具弹性,光泽。皮肤与肺的肺的呼吸作用。待以发挥,缺少糖分则皮肤枯萎干燥。皮肤的呼吸作用衰退,故感觉疲倦乏力。心属火,肾属水,因心肾的衰弱,又被禁吃饭,禁吃糖,脾属土,土不得甘,不能生长万物。脾主肌肉。肌肉因而消瘦失去弹性。心脏无法获得氧气供应,肾水亏虚不能涵养肝水,导致疏泄条达不畅。精神压抑,目腈得不到涵养。造成瘀滞引起眼疾,甚至盲目,无论哪一胀器缺失营养和糖分的丢失,都会出现头痛头晕。呕吐出汗以及全身震颤。呼吸困难,思睡,失眠无力饿的发慌的症状。甚至昏迷,低血糖的现象出现。古代中医对营养和治疗的区别。如孙思邈论述“是故食能排邪而安五脏六腑,悦神爽态,以资气血若能用食平释情遗疾者可谓良工,长年饵老之奇法,极养生之术也”,夫为医者当须先调晓病源,知其所犯,以食治之,食疗不愈,然后命药,就医学角度而言,古今中外的食物都可以治疗疾病的(药食同源)《千金要方食治谷米第四》所到二十七种谷物及制品,明确提到消渴或同时提到消与渴,共五种:第一:小麦养肝止消止渴;第二:大麦宜心主消渴;第三:青梁米,补脾除消渴;第四:绿豆清肺主消渴;第五:陈粟米,利肾主消渴。
Human body is a miniature of the earth and sky system as they have the same functioning and changing process. For example, when the weather outside is very hot, it will lead to heavy sweating, causing salt loss. At this time, we need to drink a glass of salt water to replenish salt, and when thirsty, we need a glass of sugar water to replenish sugar, just as the soil is moistened by rain. Sugar is sweet and can enter the spleen. The spleen is attributed to soil. Soil can grow and nourish all things in the earth, and it generates metal. When the soil is nourished, metal will flourish and water will be produced. When clouds fall, they become rainwater, which can lower the temperature, but when water vapor rises, they become clouds, leading to temperature rise. The spleen governs the muscle. If the property of soil in spleen is strong, the digestion of body will be good, and muscle will be strong. Children like to eat sugar, because sugar governs Yin and can supply fast-growing sugar for muscles. If the nutrient of spleen is full, the whole body will be moisturized, muscles will be strong, and the skin will be elastic and glossy. Skins and lungs are ready to play their respiratory roles. By lack of sugar, skins will wither and dry, and the respiratory function of the skin will decline, so people will feel tired. Heart is native to fire, kidney is native to water and spleen is native to soil. Because of the weakness of heart and kidney, it is restricted to eat and sugar is forbidden. Therefore, the spleen cannot work normally without nourishment. The spleen governs the muscle. Once the spleen has problems, the muscles will lose elasticity, the heart cannot get oxygen supply, kidney water deficiency cannot conserve liver water, leading to poor drainage and mental depression. The eyes cannot get water nourishment, resulting in stasis and causing eye diseases, or even blindness. No matter which organ loses nutrition and sugar, it will have headache, dizziness, vomiting, sweating, tremor, dyspnea, sleepiness, insomnia, hunger and intolerance, or even coma and hypoglycemia. The difference between nutrition and treatment in traditional Chinese medicine. As Sun Simiao said, "Because eating can dispel evil and coordinate viscera, pleasure mood, and Nourish Qi and blood, it would be great to treat diseases through diet. As a doctor, we should first find out the root cause of the disease, and adjust it through diet firstly. If it doesn't work, and then prescribe medicine for treatment. From the medical point of view, whenever and wherever food is, it can be used to treat diseases (medicines and food are homologous). Twenty-seven kinds of cereals and products mentioned in theGolden Prescriptions--Food Treatment--IV Grainsclearly refer to the emaciation of thirst or at the same time to the emaciation of thirst,including the following five types: first, wheat has the effect of nourishing liver and stopping diabetes; second, barley has the effect of benefiting heart and treating diabetes; third, foxtail millet seed has the effect of invigorating spleen and removing diabetes; fourth, mung bean has the effect of clearing lung and treating diabetes; fifth, old rice has the effect of benefiting kidney and treating diabetes, all of which have the effect of improving the quality of Qi-blood.
《素问.经别论》:“食人于胃,浊气归心,淫清于脉,脉气流经,经气归于肺,肺朝百脉,输精于皮毛,毛脉合精,行气于府,府精神明,留于四脏,气归于权衡,权衡以平,气口成寸,以决生死,这里介绍了血液与营养的关系,故营养的目的是获得高质量的血液,人的健康需要全面营养,任何一种所需要营养缺乏都会导致健康问题,消渴病人也是这样。”消渴病和生活方式有关:
As said inYellow Emperor's Inner Canon--Basic Questions: “Food enters the stomach for digestion, and then produces the turbid part of the dietary essence, which is transported to the heart and eventually the nutrients are delivered to all parts of the body by the heart through the meridians. Then, the essence returns to the lungs. Because the lungs connect numerous meridians, the lungs transport the essence to the arterioles. When the essence in the fur and meridians converges, it will return to the veins. The food essence in the blood are constantly changing through the interaction of yin and yang, and flow into the viscera under the control of the heart. These normal physiological activities depend on the balance of yin and yang in Qi-blood, which is reflected in the change of the pulse. The change of the pulse can determine the life and death of the disease. Diabetes is related to lifestyle:
1.暴饮暴食,过食肥甘,饮酒过度
Overeating, overeating fatty foods, and overdrinking
2.生活无规律,子时不睡,鸡鸣不起
Irregular lifestyle
3.盛状之时,房事过度,致肾水枯竭,水虚不能制火
Excessive sexual affairs lead to the exhaustion of kidney water, and eventually kidney deficiency cannot suppress fire.
4.年老阴衰,多肾阴亏虚损,虚火上炎,肾失因涩则溲频饮溲二也。
Because of aging and Yin failure, the kidney is deficient, which leads to the rise of deficiency fire and eventually leads to diabetes.
5.七情内伤或喜恕不节,情志不舒,耗乱气血
Temperament, mood disorder, leading to Qi-blood disorder
6.或忧思过度,伤及心脾,则营阴暗耗胃与大肥俱失通润而肌肉风消。
Because excessive worry hurts the heart and spleen, the vital essence will be depleted, the stomach and large intestine will be impaired, and the muscles will no longer be strong.
那么错误的认知也将会成为健康的绊脚石,为什么不把尿糖当做指标?人们发现有时尿糖高时血糖却在缓解;所以尿糖高时可能缓解的出口在相关的降糖药物不断开发和使用中,人类最近的消渴病和死亡率却不断上升成为人类健康的主要杀手,消渴病的治愈不要盯在降糖的指标上面,在2008年美国ACCORD研究2009年IVICE-SUGAR研究结论发表之后,血糖放松控制已成为主流观点,人体有自我保护性反应,当消渴病人代谢功能衰退则需要更多的能量与营养支持,才出现血糖升高,才能维持必要的新陈代谢,高血糖的出现通常是人体自我保护性反应,良性血糖升高是身体恢复的必由之路《黄帝内经》上早就描述过有这种人存在,“粗工凶凶以为可攻,故病为末已新病复起2型消渴初期不存在胰岛素分泌不足,而是胰岛素不敏态或是胰岛素抵抗问题,所以不要看到血糖升高就马上降糖,要看清患者的症状辨症施治,在高血糖和低血糖的关系上,主张宁可高血糖也不要低血糖”严格控制血糖和严格控制糖化血红蛋白都会导致患者生命下降和死亡率上升,那么消渴病人想要恢复正常活得久,活得好是完全可以做到的实践是检验真理的唯一标准。
What’s more, incorrect perception for diabetes can be a health stumbling block, such as treating urine sugar as an indicator. It has been found that sometimes when urine sugar is high, blood sugar is alleviating, so this discovery has been continuously developed and used in related hypoglycemic drugs. In recent years, the number of people with diabetes and its mortality rate have been rising, making diabetes the main killer of human health. The cure of diabetes should not be focused on hypoglycemic indicators. After the conclusions of the ACCORD study in 2008 and the IVICE-SUGAR study in 2009 were published, the relaxation of blood sugar control has become the mainstream view. The human body has a self-protective response. When the metabolic function of diabetic patients declines, more energy and nutritional support are needed. Therefore, blood sugar will rise to maintain the necessary metabolism. The appearance of hyperglycemia is usually a self-protective reaction of the human body. Benign hyperglycemia is the only way for the body to recover. Just as said inYellow Emperor's Inner Canon: “In the absence of a deeper understanding of the cause of the disease, the sloppy prescribing will eventually lead to the old disease not being cured, and the new disease will appear again.” There is no problem of insufficient insulin secretion in the early stage of Type II diabetes, but the human body is insensitive to or resistant to insulin. Therefore, do not immediately take hypoglycemic measures when blood sugar rises, but to identify and differentiate the symptoms of patient before delivery of treatment. In the relationship between hyperglycemia and hypoglycemia, it should be advocated that hyperglycemia is preferable to hypoglycemia. Strict control of blood sugar and glycosylated hemoglobin can lead to a decline in life and an increase in mortality. Therefore, for people with diabetes, return to normal, live long and live well are completely achievable. Practice is the only criterion for testing truth.
隋唐时期名医孙思邈在《千金方》记载:“不减滋味不戒嗜欲,不节喜恕,病己而可复作,消渴治愈后,复发的第一原因是不减滋味,是生活方式的疾病,消渴以后,脂肪分解量大,血糖也就随之增高,谷物有助于人身体恢复糖代谢的功能,也是为了平衡气血,所以我依然坚持中医数千年来的天人合一的观念,注重中医的整体观念,以其达到气血阴阳平衡,经络者处生死决百病,经络通畅,气血畅通无阻,才能达到正气内存邪不可干,消渴病人,上焦中焦下焦皆有经络阻滞,臃肿不通,可用针灸调理经络以其达到气血阴阳平衡,食药补其营养如患者上消症状明显可消润肺金,生津止渴。针灸取穴;肺俞,合谷,鱼际,廉泉,照海三阴交,中消症状明显,清胃火,通腑气”。
Sun Simiao, a famous doctor in Sui and Tang Dynasties (581-907), wrote inGolden Prescriptions: “Diet does not reduce the taste, life does not abstain from appetite, work moodily, which will lead to the recurrence of old diseases.” The first reason for the recurrence of diabetes after treatment is that the diet does not reduce the taste, which is a disease of lifestyle. After suffering from diabetes, a lot of fat will be decomposed, and blood sugar will increase accordingly, but cereals can help the body restore the function of sugar metabolism, and balance the Qi-blood. Therefore, I still adhere to the theory that man is an integral part of nature in TCM for thousands of years, and pay attention to the overall concept of TCM, so as to achieve the balance of yin and yang in Qi-blood. Only when the channel and Qi-blood are unblocked can the positive Qi be stored in the body and the internal evil be removed. The upper, middle and lower Jiao of diabetic patients are all blocked in channel, so acupuncture can be used to regulate channel to achieve the balance of yin and yang in Qi-blood, take Chinese medicine to supplement its nutrition. If the symptoms of upper emaciation are obvious, it can play the role of moistening the lung, helping produce saliva and slaking thirst. Apply acupuncture to Feiyu, Hegu, Yujian, Lianquan, Zhaohai, and Sanyinjiao. If the symptoms of middle emaciation are obvious, it can have the effect of clearing stomach-fire and clearing fu-qi.
取穴:中脱,天枢,大都,陷谷,三阴交,太溪,下消症状明显:滋补贤阴。
Apply acupuncture to Zhongtuo, Tianshu, Dadu, Xiangu, Sanyinjiao, and Taixi. If the symptoms of lower emaciation are obvious, it can have the effect of nourishing Yin.
取穴:贤俞,太溪,三阴交,照海,少商尺泽,曾经有一患者,在2012年6月见诊,班先生男56岁,患者消渴病6年有余,未见诊时其太太用轮椅推着他来见诊,因患消渴三年后又得一次中风,导致下肢溃烂,站立行走困难,望诊面色灰暗,无光泽,消瘦,神疲无力,自诉口干无味,口渴欲饮,总想吃西瓜,但医生吩嘱不能进甜食,包括西瓜,因患者精神压力较大,睡眠较差舌苔白黄厚膩,舌尖红,舌边两侧有齿痕,脉沉,细,涩。
Apply acupuncture to Xianyu, Taixi, Sanyinjiao, Zhaohai, Shaoshang, Chize. There was once a patient, Mr. Ban, a 56-year-old man, who was wheelchaired by his wife to treat in my department in June 2012. The patient suffered from diabetes for more than 6 years and had a stroke three years later, which resulted in festering of lower limbs and difficulty in standing and walking. The patient's face was grey, dull, thin, weak, dry and tasteless, thirsty, and always wanted to eat watermelon, but the doctor ordered that no sweets, including watermelon, should be taken. Because of the patient's mental stress, he had a poor sleep, a tongue coating with white, yellow, thick and greasy, red tongue tip, dental marks on both sides of the tongue, and a sinking pulse with fine and astringent.
这位患者因久病导致阴阳俱虚,热燥伤其津液,导致上焦,中焦,下焦瘀阻不通。
This patient suffers from deficiency of yin and yang due to this chronic illness, and the heat is dry and hurts his body fluid, resulting in obstruction of upper Jiao, middle Jiao, and lower Jiao.
治则:袪除火热湿之毒,疏通经络,滋补贤水,调理平衡。
Treatment method: Eliminate the poison of heat and dampness, dredge the meridians, nourish the water of the body, so as to regulate the balance of the body.
针灸取穴:大椎穴(刺络放血)太冲,太溪,中胱,天枢(毫针刺);气海,关元,胰俞,脾俞,肾俞,足三里,三阴交,大椎穴(刺络放血)因大椎穴是手足阳明经的交会处,能除热,火,湿气之毒。
Apply acupuncture to Dazhui (bloodletting), Taichong, Taixi, Zhong-guang, Tianshu (stimulated by needle), and then select the acupuncture points of Qihai, Guanyuan, Yiyu, Piyu, Shenyu, Zusanli, Sanyinjiao, Dazhui (bloodletting). Because acupuncture point of Dazhui is the intersection of Yangming Meridian of Hand and Foot, it can remove the poison of heat, fire and dampness.
太冲:宣畅厥阴气机
Tai Chong: dredging meridian Jueyin and boosting flow of Qi.
太溪:三阴交,照海:滋肾水,养肺金
Taixi, Sanyinjiao and Zhaohai: nourishing kidney water, raising lung metal
天枢中腕:清胃火,通腑气
Tianshu and Zhongwan: removing gastric fever, and regulating qi of Fu organs.
气海,关元,补充元气。胰俞,脾俞,肾俞,通达本经经络
Qihai and Guanyuan: supplementing Promordial Qi. Yiyu, Piyu and Shenshu: dredging the attributable meridians and channels.
方药:鬼箭羽20g知母15g炙甘草12g天花粉15g白术15g茯苓15g石膏20g(先煎半小时)
Prescription: 20g of Ghost Arrow Feather, 15g of Anemarrhena asphodeloides, 12g of Roasted Licorice, 15g of Trichosanthes, 15g of Atractylodes macrocephala, 15g of Poria Cocos, and 20g of Gypsum (Decoction for half an hour firstly).
水煎服:早晚各一杯,汤药服后半小时再服六味地黄丸,早晚各一丸
It should be decocted in water for oral dose. Take one cup in the morning and evening respectively, and then take one pill ofLiuwei Dihuang Pillshalf an hour later, two times a day.
调理一个月后患者的渴热现象基本消失,能够站立行走,善后调理方药:沙参9g黄芪20g石斛15g.赤灵芝15g熟地35g独活20g牛膝15g
After a month of treatment, the patient's thirst-heating phenomenon basically disappeared, and he was able to stand and walk. The prescription after treatment is: 9g of root of straight ladybell, 20g of Astragalus, 15g of Dendrobium, 15g of Ganoderma lucidum, 35g of prepared rhizome of rehmannia, 20g of radix angelicae tuhuo, and 15g of radix achyranthis bidentatae.
经善后调整1个月患者原来血糖15.8.调理后基本平稳达到正常身体症状全愈比原来胖了12斤达到正常体重。
The patient's original blood sugar was 15.8, after a month of treatment, his blood sugar was basically stable, the body condition reached normal, and his symptoms were all healed. He gained 6 kg more weight than before, and his body weight returned to normal.
治疗消渴病依然要看患者的体质症状,进行四诊合参,八钢辨证,气血,阴阳,表里,虚实,辨证,施治,诊断准确,取穴得当,开方,不要总是盯在血糖的指标上面,患者的症状消失,血糖才会平稳,才是康复的真正意义,真正健康了,才能做到活的好,活得久,才能达到天人合一的自然规律,以养天年,幸福快乐!
Treatment of diabetes mellitus is still based on the physical symptoms of patient and needs to combine the four diagnostic methods to comprehensively differentiate the symptoms. By analyzing Qi-blood, Yin and Yang, exterior and interior, deficiency and excess, syndrome differentiation, treatment can be delivered, Make sure the diagnosis is correct and the acupoints applied to and prescription given are appropriate. Don't always focus on the blood sugar indicator. When the symptoms of patients disappear, blood sugar will be stable, which is the real indication of rehabilitation. Only when we are truly healthy can we live well andlongfor a long time, can we maintain in line with the nature law that man is an integral part of nature, and thus to enjoy a happy life!
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