The “Unified Qi Circulation” theory, pioneered by Huang Yuanyu (imperial physician of the Qing Dynasty), emphasizes the pivotal role of the ascending-descending flow of qi in maintaining health. Obesity-type type 2 diabetes mellitus (T2DM), classified as “consumptive thirst” or “spleen heat” in Traditional Chinese Medicine (TCM), is a prevalent metabolic disorder closely associated with insulin resistance and dyslipidemia, posing significant clinical prevention and treatment challenges. Chronic metabolic dysregulation exacerbates obesity, while obesity further aggravates glucolipid metabolic imbalances, creating a vicious cycle. This paper analyzes current epidemiological trends of obesity-type T2DM and the core tenets of the “Unified Qi Circulation” theory, underscoring the importance of qi dynamics in metabolic homeostasis. Proposing the three key pathogenic mechanisms of obesity-related T2DM from the perspective of traditional Chinese medicine: endogenous damp-heat from dietary excess; turbid lipids accumulation due to splenic dysfunction; and blood stasis obstructing collaterals from impaired liver-mediated regulation. The mechanisms corroborated by modern findings on insulin resistance and inflammatory responses. Therapeutically, we advocate the “Unified Qi Circulation” framework as the guiding principle, integrating interventions to clear heat, resolve dampness, drain turbidity; regulate the spleen-stomach pivot; and soothe liver qi to activate wood-phase vitality. This approach aims to restore harmonious qi flow and visceral coordination, offering novel strategies for preventing and treating obesity-type T2DM.
Yang et al. (Thu,) studied this question.