糖尿病（二）

姜淑香@秋日雏菊

从胰岛素的分配来了解血糖升高的原理？先从血糖开始说起，细胞跟人一样爱吃一口甜的，糖是它们的力量源泉，而我们的肠胃，就像糖的加工厂，把吃到肚子里的各种原材料，都变成葡萄糖。葡萄糖进入血管变成血糖，开始从你的全世界路过。与此同时，60万亿嗷嗷待哺的细胞，都等着一种叫激素的物质来完成血糖的配送，这种激素就是胰岛素。胰岛素像一个快递员呼之即来，开始上门送餐，没有它们，细胞们就都饿肚子了。血管中多余的血糖就会被胰岛素送到肝里面，暂时存起来。肝脏没地方的时候，血糖就会被肝细胞，胖揍一顿，变成脂肪，踢出门，然后，你若运动能消耗掉，你若不运动，就变成脂肪堆积在肝内。胰岛素从不丢单，从不超时，可很多人，总是在身体承受力的边缘疯狂试探，没日没夜，胡吃海喝，从来不问问自已，这么多血糖，我的细胞吃不吃得下？这么多血糖，我的胰岛素送不送得完？直到某一天，胰岛素一如既往的送货上门，但是敲门没人回答，胰岛素被拒之门外，这就是传说中的胰岛素抵抗，配送失败，胰岛素只好又带着血糖，来到了肝脏，此时，它看到了惊人的一幕，脂肪在肝内堆积，过多的血糖加重了肝的代谢负担，胰岛素外送不出去，又存不起来，无处安放的血糖呀，更充满了血液。这时，胰岛素总部----胰岛，拉响了警报，进入一级作战状态，胰岛素，全员出动，拼命救场。糖尿病前期，会有胰岛素分泌过多的症状，虽然胰岛素百分百投入配送，但是，都被拒之门我，配送失败，血糖依然蹭蹭往上涨，因为不良的饮食生活习惯和遗传因素造成了胰岛素抵抗，这是2型糖尿病的特征。 从中医阴阳来看看血糖升高的原理？先从分泌胰岛素的胰腺说起，胰岛素是由胰岛β细胞受内源性或外源性物质的激动而分泌的一种蛋白质激素。胰岛素能促进肝脏、肌肉和脂肪等组织摄取和利用葡萄糖，是体内唯一降低血糖的激素。在人体十二指肠旁边，有一条长形的器官，叫做胰腺。在胰腺中散布着许许多多的细胞群，叫做胰岛。胰腺中胰岛总数约有100～200万个。主要的作用，就是调节体内的血糖的情况的了。是可以帮助降血糖的作用的了。经常很多人也把糖尿病叫做富贵病，认为和饮食结构有莫大的关系，是吃出来的毛病，当然其根本原因还是体能机制出现功能失调，现代研究也追溯到胰腺功能的问题。胰腺功能，古代有少数书籍叫做沙肝，对这个器官，发现有些线索可以和三焦功能联系起来，三焦是一套庞大的系统，可以理解为体内的隔膜网格结构，三焦属少阳经，少阳配相火，从而糖尿病的内火消渴症状，和少阳相火可以对应起来。少阳，包括手少阳三焦经和足少阳胆经，少阳相火应该就是指的胆火，相火，是相对于君火而言的，即君主，其他脏腑的火都叫宰相火，即宰相。三焦和胆道是身体的下水道网，另一条高速公路。三焦淤堵，肝胆系统也会堵，胆和三焦互为表理，肝胆又相照。三焦和胆都堵了，肝只能把气机向上移，全身气机，也因为三焦堵而上升，上焦就容易气多，多加一点阳热之气的药，就上焦燥热。下焦淤堵，寒湿。这个堵是必须的，下焦阳是肯定不足的，有多少不足就有多少寒湿，不足的阳虚到一定程度，无力运温化水油湿，过盛营养蛋白转化过程中断。就一定出现三焦上热、下寒、中虚的现象。 《临证指南医案》所云：“三消之病，三焦受病也。上消者，渴证也，大渴引饮，随饮随渴，以上焦之津液枯涸。古云其病在肺，而不知心脾阳明之火皆能熏灸而然，故又谓之膈消也。中消者，中焦病也。多食善饥，不为肌肉而日加消瘦，其病在脾胃，又谓之消中也。下消者，下焦病也。小便黄赤，为淋为浊，如膏如脂，面黑耳焦，日渐消瘦，其病在肾，故又名肾消也。”我国古代记载糖尿病叫做“消渴”或者叫“三消”。三消论治：上消属肺，中消属胃，下消属肾，分别代表糖尿病三个不同的脏腑和病变阶段。清•程国彭《医学心悟•三消》云“治上消者，宜润其肺，兼清其胃”；“治中消者，宜清其胃，兼滋其肾”；“治下消者，宜滋其肾，兼补其肺”，可谓深得临证要旨。《王旭高医案》记载：“消渴日久，但见手足麻木，肢凉如冰。” 根据不同的病位和病机可制定不同的治疗原则，如清热润肺、清胃泻火、养阴补肾、滋阴生津。可是很多早期糖尿病患者根本表现不出三消的症状来，但是通过检查，确确实实患上了糖尿病。通过辩析其不同的类型可施以不同的治疗手法。 阴虚燥热型：从中医的角度上看，所谓口渴是因为体内有火有热，也就是火炎于上、阴亏于下，水火不相济所致。水源不充，体内的火就旺盛，津液亏竭，渴饮无度；热还可以伤胃，使人容易饥饿，肌肤消瘦。此外，热会伤肾，造成精气亏虚，尿量频多。这就是三型辨证理论的第一种类型，也是糖尿病人最常见的类型之一。由于阴虚燥热型多见于糖尿病早期，若能积极治疗，均可恢复如初。但是与西医一样，中医也是不可能根治糖尿病的，所谓恢复如初，指的是改善临床症状，维持正常的血糖，而并不是完全治愈。 气阴两虚型：因阴虚燥热可以伤阴耗气，而致气阴两虚。患者通常因心脾气虚而神疲乏力，出汗气短，心悸失眠，怔忡健忘、因肝肾阴虚而五心烦热、易怒暴躁等症。该型既是糖尿病并发症发生的早期阶段，也是并发症加重的病理基础、是并发症演变的枢机和防治的关键。 阴阳两虚型：此型多以心肾不足，脾肾阳虚为主，往往发生于糖尿病后期，并发症多而严重。这个时期患者表现为畏寒倦卧、四肢不温、肢体浮肿、大便泄泻、小便清长、阳痿遗精等。脾肾阳虚，同时可伴心烦失眠，口干喜热饮等心肾阴虚之阴阳两虚症。多见于糖尿病并发心血管、脑血管、肢体血管、以及肾，视网膜病变等病变，本型病情复杂。通过温补脾肾、益气养阴、活血化瘀类药物治疗，可延缓病情发展，减轻痛苦，提高生活质量，延长生命。 　　这三种类型中，气阴两虚型是防治并发症发生和发展的关键，所占比例高达75.9%，故认为是糖尿病基本症型。阴虚燥热型占11.2%、阴阳两虚型占12.9%。如果对气阴两虚型进行合理调治，那么就可以有效控制糖尿病并发症的发生和发展，如果调理的不好的话，就很有可能转为第三期。 青岛环语翻译公司业务联系电话：15588617120 联系人：姜淑香QQ邮箱：634363114@qq.com微信：qq634363114 Diabetes (2)To learn about the mechanism of elevated blood sugar from insulin distribution? Let’s start with blood sugar. Cells love a sweet bite just like human do, and the sugar is their source of strength. And Our intestines and stomach like a sugar factory turn every raw material which we eat into glucose. Then the glucose comes into blood vessels and becomes blood sugar, which begins to pass through our whole body. At the same time, 60 trillion hungry cells are waiting for a kind of called hormonal substance to finish the distribution of blood sugar, the hormone which is insulin. The insulin comes at our call like a food-delivery staff who starts to deliver food from door to door, and without them, the cells would starve. If there are excess blood sugar in the blood vessels that will be send by the insulin to liver, where they are stored temporarily. But if there is no room in the liver for the excess blood sugar, which will be knocked by the liver cells, turning into fat, and kicking out the door, and then the fat is either accumulated in doorways or is burned off by exercise. In fact, insulin never misses any food orders, never late for sending work, but a lot of people always try frantically at the edge of what our body can handle, eating and drinking day and night, never asking themselves, so much blood sugars, can our cells eat it all up? and can our insulin finish to send it? Until one day when insulin delivers food to the door as usual, but no one comes to answer at the door, so the insulin is refused and also this is known as insulin resistance. when delivery fails, the insulin has no choice but to take the blood sugar with it to the liver, but right now the insulin saw an amazing scene, fat accumulated in the liver, excessive blood sugar aggravated the metabolic burden of the liver, as a result, insulin can not be sent out or stored, and there is no place for blood sugar so they are full in the blood. At this time, the insulin headquarters ---pancreas islet sounded the alarm into to level-1 combat state, insulin all is out and desperately to save the field. That is why at pre-diabetes there occurs symptom of excessive secretion of insulin, although insulin was 100 percent put into delivery, it was still rejected, and with the delivery failure the blood sugar keeps rising. Because poor eating and living habit and genetic factor cause the insulin resistance, which is characteristic of type 2 diabetes. To learn about the mechanism of elevated blood sugar from the views of traditional Chinese medicine? Let’s start with pancreas which secretes insulin. The insulin is a kind of protein hormone secreted by pancreatic beta cells that are agitated by endogenous and exogenous substances, as well as it can improve such tissues as liver and muscles and fat to take in and utilize glucose as the only hormone that can reduce blood glucose in the body. It is next to the duodenum that there is a long organ called the pancreas, throughout which is scattered numerous groups of cells called islets. There are about one or two million islets in the pancreas. What these islets in the pancreas are main function is to adjust and reduce the blood sugar of the body. Many people often called diabetes as illness of affluence, and believe in that diabetes is related to the dietary structure, eating disease. Certainly the root cause is the dysfunction of the physical mechanism, and modern research also traces to the problem of pancreatic function. About the pancreas function, there are a few ancient books recorded that the pancreas called as sand liver and there are some clues that can be linked to the function of the triple energizer, the largest fu-organ in the human body, which can be understood as the diaphragm grid structure of the body. And the triple energizer(sanjiao) belongs to a shaoyang meridians and when it collocates with ministerial fire, they can imply the internal fire thirsting disorder symptoms of diabetes. So they can be analyzed with the Yin-Yang theory of Shaoyang matching ministerial fire. Among three-Yin and three-Yang, shaoyang meridians include hand shaoyang sanjiao meridian and food shaoyang gallbladder meridian. For shaoyang matching ministerial fire, the fire refers to gallbladder fire. What is called ministerial fire is just relative to monarch fire, also called the monarch, and other viscera organs are called as ministerial fire, meaning ministers. The triple energizer and gallbladder are the body’s network of sewers, another highway. With Sanjiao waterway blockage, hepatobiliary system will be blocked, because sanjiao, internally and externally is related with gallbladder, and because gallbladder, internally and externally is related with liver. If sanjiao and gallbladder are both blocked, the liver can only change its qi-energy upward, the whole body qi-energy does the same. And then the upper-jiao is easy to accumulate excess qi-energy, and adding a little more medicine with Yang-qi can made the upper-jiao hot meanwhile the lower-jiao cold-dampness according to the Yin-Yang balance theory. Due to the blockage at the lower-jiao, the lower-jiao Yang-qi is definitely not enough to some extent that the transportation and transformation of water, oil and wet will be weak, for there is as much Yang-deficiency as there is cold and damp, thus the transformation process of hypertrophic protein is interrupted. There must appears a phenomenon in the triple energizer with the upper-jioa heat, the middle-jiao deficiency, and the lwer-jiao cold. “Clinical guide medical case” said: “sanxiao disease is sanjiao disease as well.” The xiaoke lesion of the upper-jiao of those who are drink and thirst at all hours leads to the body fluid at the upper-jiao dried up. Ancient says that the thirst symptom is in the lung but the Yangming fire is in the heart and spleen which is not known can also cause the fire, so called the remote fire suppression. The xiaoke lesion of the midder-jiao of those who are often hunger and eating more results the body to waste away however, for the disease is in the spleen and stomach, also called the middle fire suppression. And the xiaoke lesion of the lower-jiao of those whose urine is red and cloudy from the shower like cream or fat, causes the blackish complexion and ear dry, losing weight gradually, for the disease is in the kidney, also called diabetic nephropathy. In our ancient recorded diabetes was called the symptom of“xiaoke” or “the three urinary deficiencies”. In the therapy, three types of diabetes treatments are applied to quench the upper-jiao lung thirst, to quench the midder-jiao stomach thirst, and to quench the lower-jiao kidney thirst, which represent three different stages of viscera and lesions of diabetes. Chen Guopeng was a famous doctor of the Qing Dynasty, said in the treatise of“Medical Heart Understanding•Sanxiao”, that “curing the upper-jiao should moisten its lung and clear its stomach”; “curing the middle-jiao should clear its stomach and nourish its kidney”; “curing the lower-jiao should nourish its kidney and supplement its lungs”, which gets to the main idea of diabetes. According to the recording of “Wang Xugao’s Medical case”: quenching thirst for a long time, but only see hands and feet numb becoming as cold as ice. According to different disease location and pathogenesis, different treatment principles can be formulated, such as clearing heat and moistening lung, clearing stomach and eliminating fire, nourishing Yin and tonifying kidney, nourishing Yin and generating body fluid. But, many patients with early diabetes do not show the sanxiao symptoms, yet, through the examination, they really suffer from diabetes. Through the identification of its different types, the symptoms can be imposed different treatment techniques. First, Yin deficiency and fire-excess type: in views of traditional Chinese medicine, the so-called thirst is caused by the presence of fire and heat in the body, that is, fire on the upper, Yin deficient on the lower, water and fire can’t be mutually beneficial. Without sufficient water, the fire in the body becomes flourishing, the body fluid is depleted, and the thirst for water is boundless. Heat can also hurt the stomach, making people easy to hunger, skin wasting. In addition, the heat can hurt kidney, causing qi deficiency and frequent urination. This is the first type of the three-type syndrome differentiation theory, and is one of the most common types of diabetes. Because Yin deficiency and dry heat type are very common symptom in early diabetes, it can be restored if it can be actively treated. However, like western medicine, traditional Chinese medicine is also impossible to cure diabetes completely. The so-called recovery refers to the improvement of clinical symptoms and the maintenance of normal blood sugar, rather than a complete cure. Second, qi-Yin deficiency type: because of Yin deficiency and fire excess can hurt Yin and consume Qi-energy, causing both Qi and Yin deficiencies. Patients usually suffer from fatigue, sweating, shortness of breath, palpitation, insomnia, palpitation, irritability and other symptoms due to deficiency of lover and kidney Yin. This type is not only the early stage of the occurrence of diabetes complications, but also the pathological basis of the aggravation of complication, the key to the evolution of complications and the key to the prevention and treatment. Third, Yin-Yang deficiency type: this type is mainly characterized by deficiency of heart and kidney, deficiency of spleen and kidney Yang, which often occurs in the late stage of diabetes with serious complications. In this period, patients are chills and tired of lying, limbs are not warm and bloated, diarrhea, urination is clear and long, impotence and spermatorrhea. Spleen and kidney Yang deficiency are also companied with upset insomnia, dry mouth which likes hot drinks and other heart and kidney Yin deficiency and Yin-Yang deficiency. More common in diabetes is complicated with cardiovascular, cerebrovascular, limb blood vessels, as well as kidney, retinopathy and other lesions, the condition is complex. By warming the spleen and kidney, nourishing qi and Yin, and promoting blood circulation and removing blood stasis drug treatment, can delay the development of the disease, relieve pain, improve the quality of life, and prolong life. Among these three types, qi-yin deficiency is the key to prevent and cure the occurrence and development of complications, and accounts for up to 75.9%, so it is considered as the basis diabetes syndrome. Yin deficiency and hot and dry type accounts for 11.2%, Yin-Yang deficiency type accounts for 12.95. If the qi-Yin deficiency type is treated reasonably, the occurrence and development of diabetes complications can be effectively controlled. If the conditioning is not good, it is likely to be turned into the third stage. Qingdao Global language translation CompanyBusiness Call: 15588617120Contact person: Jiang ShuxiangQQ E-mail: 634363114@qq.comWeChat:qq634363114