基于“虚气留滞”理论探讨糖尿病胃轻瘫的论治
Discussion on the Treatment of Diabetic Gastroparesis from the Perspective of “Qi Deficiency and Stagnation”

糖尿病胃轻瘫(DGP)是糖尿病的常见并发症之一，以恶心呕吐、腹泻腹胀，甚至是腹痛等症状为主要临床表现，严重影响糖尿病患者的生活质量及血糖控制水平。现代医学研究指出，DGP可能与多种因素相关，包括但不限于自主神经系统异常、肠道神经病变、卡哈尔间质细胞(ICC)损伤、成纤维细胞数量减少以及血糖水平急剧波动等，但具体的发病机制尚未完全明确。目前西医疗法存在不良反应多、适应证严格等诸多不足，中医整体观和辨证论治的理念有助于医者从多角度论治疾病。中医认为糖尿病胃轻瘫乃本虚标实之证，“虚气留滞”是关键病机。虚气不荣，以虚为本；留滞难通，以滞为标。“留滞”为病机之标，“虚气”之果，且“留滞”之瘀血、痰湿等病理代谢产物与现代医学的病理表现有一定相关性。“虚气”与“留滞”相互影响，形成糖尿病胃轻瘫本虚标实的病机特点。故文章从“虚气留滞”角度切入，探析糖尿病胃轻瘫，并从多个方面深层次剖析糖尿病胃轻瘫的发病机理，为防治糖尿病胃轻瘫提供新思路和方法。
Diabetic gastroparesis (DGP), a common complication of diabetes mellitus, manifests clinically as nausea, vomiting, diarrhea, abdominal distension, and even epigastric pain, significantly impairing patients’ quality of life and glycemic control. Modern medical studies suggest multifactorial pathogenesis involving autonomic dysfunction, enteric neuropathy, interstitial cells of Cajal (ICC) impairment, reduced fibroblast populations, and acute glycemic fluctuations, though the exact mechanisms remain elusive. Current Western therapies face limitations, including adverse effects and restrictive indications. Traditional Chinese medicine (TCM), guided by its holistic diagnosis and syndrome differentiation principles, offers multidimensional therapeutic strategies. TCM posits DGP as a deficiency-rooted excess syndrome, with “Qi Deficiency with Stagnation” as the core pathogenesis. Qi deficiency fails to nourish, taking deficiency as the root; stagnation impedes movement, taking stagnation as the manifestation. “Stagnation” is the manifestation of pathogenesis, the consequence of “qi deficiency”, and pathological metabolic products related to “stagnation”, such as blood stasis and phlegm-dampness, have some correlation with the pathological manifestations in modern medicine. “Qi deficiency” and “stagnation” influence each other, forming the characteristic pathogenesis of diabetic gastroparesis as a deficiency in origin and excess in superficiality. Thus, the article approaches from the perspective of “stagnation due to qi deficiency”, exploring diabetic gastroparesis, and deeply analyzes its pathogenesis from multiple aspects, providing new ideas and methods for the prevention and treatment of diabetic gastroparesis.