通讯作者: 钟文亮, 2359705536@qq.com

DOI：10.12201/bmr.202603.00064

Discussion on the Treatment of Diabetic Cardiomyopathy from Spleen Yang Deficiency and Decline Based on the Theory of Yang Deficiency with Three Depletions Governed by the Spleen

• 摘要：糖尿病心肌病是糖尿病严重的特异性心肌病变，传统认识侧重阴虚燥热，但多数患者存在明显阳虚表现，病情进展与“精、气、火”渐进损耗密切相关。“阳虚三夺统于脾”，是以脾阳为核心，阐释“夺精、夺气、夺火”传变规律，该理论所揭示的虚损次第与本病早期心肌代谢紊乱，中期心肌纤维化，晚期心力衰竭的病程契合。故本文基于此理论，以脾阳虚衰核心，探析糖尿病心肌病“夺精、夺气、夺火”病机演变规律，并提出相应的辨治体系，以期丰富糖尿病心肌病的中医诊疗思路。

  关键词： 糖尿病心肌病；阳虚三夺统于脾；脾阳虚衰；中医药；; ; ; 

   

  Abstract: Diabetic cardiomyopathy (DCM) is a specific myocardial lesion of diabetes mellitus independent of coronary heart disease and hypertension, with abnormal myocardial energy metabolism, microvascular injury and fibrotic remodeling as its core pathological characteristics. In traditional Chinese medicine (TCM), DCM is categorized into the scopes of Xiaoke Disease and Palpitation. Traditional cognition mainly focuses on Yin deficiency and dryness-heat, while clinical practice shows that most patients present with obvious Yang deficiency manifestations, and disease progression is closely related to the gradual depletion of essence, Qi and fire.Wang Qishi put forward the theory of Yang Deficiency with Three Depletions Governed by the Spleen, which takes Spleen Yang as the core and expounds the transmission and transformation rules of essence depletion, Qi depletion and fire depletion, which is highly consistent with the clinical characteristics of DCM. Based on the above theory, this paper proposes that Spleen Yang deficiency and decline is the core pathogenesis of DCM, and its transmission and transformation follows the sequence of essence depletion, Qi depletion and fire depletion. Accordingly, a therapeutic system is established: invigorating the Spleen and warming Yang, consolidating the root and replenishing essence; replenishing Qi and invigorating the Spleen, activating blood circulation and inducing diuresis; tonifying fire to rescue reversal, warming Yang and securing collapse. This study aims to enrich the TCM diagnosis and treatment strategies for DCM.

  Key words: Diabetic Cardiomyopathy; Yang Deficiency with Three Depletions Governed by the Spleen; Spleen Yang Deficiency and Decline; Traditional Chinese Medicine

  提交时间：2026-03-17

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• 序号	提交日期	编号	操作
  1	2026-03-08	10.12201/bmr.202603.00064V1	下载

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