中医杂志

总结魏子孝教授从太阴、少阴辨治糖尿病合并泌尿系感染的经验。以六经太阴、少阴为辨证纲领，提出脾肾两虚、气化失司为本，湿热下注为标的核心病机，认为消渴与淋证同源异流、同根共病，久病多虚实夹杂、缠绵难愈。临证将本病分为太阴证、少阴寒化证、少阴热化证、太阴少阴合病四型，以复太阴脾运、助少阴气化为治疗关键，分别采用补中益气、温肾化气、滋阴通淋、扶正通淋法，方选补中益气汤、济生肾气丸、知柏地黄丸合猪苓汤、补中益气汤合济生肾气丸等加减，慎用苦寒、重在扶正、标本兼顾。

This article summarizes professor WEI Zixiao's clinical experience in the differentiation and treatment of diabetes mellitus complicated with urinary tract infection from the perspective of taiyin （太阴） and shaoyin （少阴）. Professor WEI takes taiyin and shaoyin in the six meridians as the core differentiation framework, and puts forward that the core pathogenesis lies in deficiency of both the spleen and kidney, and the dysfunction of qi transformation as the root, and damp-heat pouring downward as the branch. It is held that xiaoke(wasting-thirst, 消渴) and strangury originate from the same pathogenesis yet present distinct clinical manifestations. Chronic cases are mostly characterized by deficiency-excess complex, lingering and difficult to heal. In clinical practice, the disease is condensed into four syndromes, taiyin syndrome, shaoyin cold-transformation syndrome, shaoyin heat-transformation syndrome, and concurrent taiyin and shaoyin syndrome. The key therapeutic principle is to restore the transportation function of the taiyin(spleen) and to enhance the qi-transformation function of the shaoyin. The corresponding methods include tonifying the middle and replenishing qi, warming the kidney and transforming qi, nourishing yin and relieving strangury, as well as strengthening healthy qi and relieving strangury. Representative formulas include Buzhong Yiqi Decoction （补中益气汤）, Jisheng Shenqi Pill （济生肾气丸）, Zhibai Dihuang Pill （知柏地黄丸） combined with Zhuling Decoction （猪苓汤）, and Buzhong Yiqi Decoction combined with Jisheng Shenqi Pill, all with appropriate modifications. Bittercold medicinals are used cautiously, with emphasis on strengthening healthy qi and addressing both the root and the branch.