台灣臨床常用青草藥治療糖尿病之文獻回顧

Literature Review on Taiwanese Herbs Clinically Used in Diabetes Treatment

糖尿病是一古老的代謝疾病，中國古代文獻記載的「消渴」症狀─消榖善飢，口渴多飲；又因為多飲而多尿，由消耗而致消瘦之證，便歸屬於現代糖尿病的範疇。糖尿病的嚴重性在於全身微循環不良和神經病變，可對重要維生器官產生併發症，導致心血管疾病、腎衰竭、糖尿足截肢、失明等併發症。本文藉由文獻回顧之方式，首先整理出糖尿病在中醫辨證論治基礎的各種證型分類，成為方證相對的治療參考依據。透過整理市售青草藥單方濃縮製劑，從中選出七種臨床用來輔助治療糖尿病的民間青草藥─包含武靴藤、咸豐草、絞股藍、山苦瓜、番麥鬚、紅骨蛇及龍眼花；這些青草藥累積前人豐富的臨床使用經驗，在現代藥理研究方面，如：細胞試驗、動物實驗及活性化學成分的研究，亦可作為中醫師斟酌症情變化之單味藥加減的另一項選擇考量。最後，現代醫學對糖尿病及相關併發症提供不少臨床診斷的線索，若辨證審因，加減化裁常用證型處方之外，搭配青草藥做為輔助治療，發揮方藥協同的綜合效應，成為現代糖尿病治療的參考指南，使治療糖尿病達到更理想的境界。 Diabetes is an ancient metabolic disease. The medical term of “dispersion-thirst (xiao ke)? recorded in ancient Chinese literature are symptoms of excessive hunger and thirst, causing people emaciatd eventually with both drinking and urinating much. It belongs to the category of modern diabetes. The seriousness of diabetes lies in poor systemic microcirculation and neuropathy which can cause complications in vital organs; for instance, cardiovascular diseases, renal failure, diabetic foot, and blindness. In this paper, by reviewing the literature, the classification of various syndromes of diabetes on the basis of traditional Chinese medicine is first sorted out, and it becomes the reference for the treatment of prescriptions. Through the arrangement of commercially herbal concentrates, seven kinds of folk herbal medicines used for the treatment of diabetes are choosed-Gymnema Sylvestre, Bidens pilosa, Gynostemma pentaphyllum, Momordica Charantia, Zea mays, Paederia scandens, and Dimocarpus longan. These herbs have accumulated a wealth of clinical experience from previous generations and are used in modern pharmacological research such as cell tests, animal experiments, and active chemical composition studies. Therefore, they can be used as alternatives for achieving more flexible and effective treatment of Chinese medical practitioner. Finally, modern medicine provides many clinical clues for the diagnosis of diabetes and its related complications. With the use of herbal medicine as adjuvant therapy, the synergy effects of prescription and herbs can become a reference guide for the treatment of modern diabetes, which achieve an ideal and effective result.