【目的】 基于五运六气理论探讨毒损肝络与2型糖尿病的相关性。【方法】 选取2019年2月至2023年10月在长春中医药 大学附属医院内分泌代谢病科接受治疗的986例2型糖尿病患者为研究对象，探讨运气学说中的运、气因素对2型糖尿病患 者禀赋特征的影响以及毒损肝络在糖尿病发病中的作用。【结果】（1）五运六气分析方面，不同岁运和司天/在泉情况对2型糖 尿病患者禀赋无显著影响（P＞0.05）；不同主运、客运、主气与客气对2型糖尿病患者禀赋有显著影响（P＜0.05），986例2型 糖尿病患者中，主运以终之运太阳寒水为主，客运以木运不及或水运太过为主，主气以阳明燥金为主，客气以太阴湿土为 主。（2）毒损肝络与2型糖尿病的相关性方面，通过对比分析，揭示了肝脏疏泄功能在维持机体阴阳平衡及调畅气机中的主导 地位，强调了毒损肝络在糖尿病发病中的关键作用。【结论】 运气因素对2型糖尿病患者的禀赋特征有一定影响，容易罹患2型 糖尿病的人群出生日期的运气特征为：主运为终之运太阳寒水、客运为木运不及或水运太过、主气为阳明燥金、客气为太 阴湿土；毒损肝络与2型糖尿病发病密切相关，故治疗上应重视肝脏的调节作用，在辨证论治的基础上配合使用疏肝药物， 力求身心同治，以提升治疗效果，为糖尿病治疗提供了新的视角与途径。

Objective To explore the correlation between the pathogenesis of toxins damaging liver collateral and the incidence of type 2 diabetes mellitus （T2DM） based on the theory of five circuits and six qi. Methods A total of 986 patients with T2DM treated in the Department of Endocrinology and Metabolism at the Affiliated Hospital of Changchun University of Chinese Medicine from February 2019 to October 2023 were selected as the study subjects. The influences of circuit and qi indicators in the theory of five circuits and six qi on the constitutional characteristics of T2DM patients and the role of pathogenesis of toxins damaging liver collateral in the incidence of T2DM were investigated. Results （1） The five-circuit and six-qi analysis showed that the yearly circuit and sitian/ zaiquan conditions had no significant effect on the constitutional characteristics of patients with T2DM （P＞0.05）. However， dominant circuit， guest circuit， dominant qi and guest qi significantly influenced the constitutional characteristics of patients with T2DM （P＜0.05）. For the distribution of circuit-qi indicators at birth among the 986 patients，dominant circuit was predominated by the terminal circuit of taiyang cold-water，guest circuit was characterized by deficient wood circuit or excessive water circuit，dominant qi was predominated by yangming dry-metal， and guest qi was characterized by taiyin damp-earth.（2） The correlation between the pathogenesis of toxins damaging liver collateral and the incidence of T2DM through comparative analysis revealed that the conveying and dispersing function of the liver plays a leading role in maintaining the body’s yin-yang balance and ensuring free movement of qi，indicating that the critical role of toxins damaging liver collateral is the key to the incidence of diabetes. Conclusion Circuit-qi indicators have a certain influence on the constitutional characteristics of T2DM patients. The circuit-qi features at birth of the individuals prone to T2DM are as follows： dominant circuit predominated by the terminal circuit of taiyang cold-water， guest circuit characterized by deficient wood circuit or excessive water circuit， dominant qi being yangming dry-metal， and guest qi being taiyin damp-earth. Pathogenesis of toxins damaging liver collateral is closely related to the incidence of T2DM. Therefore，in treatment，the regulatory role of the liver should be emphasized，and liver-soothing herbs should be used based on syndrome differentiation， aiming for holistic treatment of the physique and the spirit and enhancing the therapeutic efficacy. The exploration will provide a new perspective and approach for the treatment of T2DM.

R259.871

国家自然科学基金资助项目（编号：82374380）；深圳市科技计划资助项目（编号：JCYJ20220531091409022）；吉林省教育厅科学 研究项目（编号：JJKH20230965KJ）