Exploring the evolution of heat pathogenesis and the application of heat-clearing treatment method in diabetes and its complications based on the "trinity" diagnosis and treatment model of constitution, disease, and syndrome differentiation

Traditional Chinese medicine (TCM) possesses unique advantages in preventing and treating diabetes and its complications. Our team proposes that "heat damaging qi and yin" is the fundamental pathogenesis of diabetes. Clinically, it is necessary to explore the evolutionary patterns of heat pathogenesis in the development and progression of diabetes and its complications under the guidance of the "trinity" diagnosis and treatment model of constitution, disease, and syndrome differentiation. Constitution differentiation clarifies the source of heat and what is damaged by heat, manages disease risk, and predicts disease progression. Disease differentiation distills the fundamental pathogenesis of diabetes and its complications, integrating TCM and Western medicine to elucidate the basic treatment method. Syndrome differentiation focuses on the dynamic evolution and primary-secondary aspects of various pathological stages. From the perspective of "constitution-pathogenesis-syndrome," a dynamic and precise treatment plan is formed based on the heat-clearing method. During the prediabetes stage, the emphasis is on constitution differentiation and heat-clearing to eliminate the heat source. During the diabetes stage, the strategy combines disease and syndrome differentiation to treat the established disease and prevent its progression. During the diabetes complication stage, the focus shifts to the transformation and outcome of heat pathogenesis. For diabetic kidney disease, where heat leads to mass, the treatment prioritizes clearing heat, resolving mass, and draining turbidity. For diabetic retinopathy, where stagnant heat resides in the liver, the main focus is clearing heat, regulating the liver, and unblocking collaterals. For diabetic peripheral neuropathy, where heat leads to flaccidity, the emphasis is on clearing heat, removing dampness, and supplementing deficiency. For diabetic foot, where heat transforms into toxin, the key is clearing heat, removing toxicity, and activating blood circulation. For diabetic cardiomyopathy, where heat consumes qi, the principle is clearing heat, promoting collapse, and unblocking vessels. This approach aims to construct an innovative TCM system to prevent and treat diabetes and its complications.