基于文献2型糖尿病周围神经病变中医证型规律及用药特点探讨  

Literature Exploration of TCM Syndrome Types and Drug Characteristics of Type 2 Diabetic Peripheral Neuropathy

作　　者：段力[1] 武凤震 梁庆顺 夏亚情 符宇[1] 范冠杰[2] DUAN Li;WU Feng-zhen;LIANG Qing-shun;XIA Ya-qing;FU Yu;FAN Guan-jie(Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong 510405, China;Guangdong Hospital of Traditional Chinese Medicine, Guangzhou Guangdong 510120, China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广东省中医院,广东广州510120

出　　处：《中医药导报》2018年第10期31-35,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家科技支撑计划课题(2015BAI04B00)

摘　　要：目的:探讨2型糖尿病周围神经病变的证型证素规律及用药特点,为中医科研和临床提供参考。方法:收集2010年1月至2016年12月期间中国知网、万方、维普公开发表的有关口服中药治疗2型糖尿病周围神经病变的的文献,对其证型、证素、治法、方药进行梳理,并采用频数分析、构成比分析、因子分析进行归纳和总结。结果:2型糖尿病周围神经病变患者常见中医证型为气虚血瘀、气阴两虚、瘀血阻络、痰瘀阻络、阳虚血瘀和肝肾阴虚;常见的病性证素为血瘀、气虚、经络、阴虚、痰、湿、阳虚,常见的病位证素为经络、肝、脾、肾,其中虚证证素为气虚、阴虚、阳虚,实证证素为瘀血、痰、湿、热、毒;常见方剂为黄芪桂枝五物汤、当归四逆汤和补阳还五汤;常用中药为黄芪、当归等;常用药对药串为黄芪系列、桃仁系列等。结论:2型糖尿病周围神经病变是本虚标实,虚实夹杂之病,本虚以气虚、阴虚为主,标实以血瘀为主,其次为痰、湿、热、毒,病位在经络,涉及肝、脾、肾三脏。气阴两虚是2型糖尿病周围神经病变的基本病机,血瘀是关键;在2型糖尿病周围神经病变的治疗上补气活血具有重要作用。Objective： To explore the syndrome types and drug characteristics of type 2 diabetic peripheral neuropathy, so as to provide a reference for Chinese medicine research and clinical practice. Methods： The literature concerning oral Chinese medicine for type 2 diabetic peripheral neuropathy, published by CNKI, Wan Fang and VIP from January 2010 to December 2016, is collected to sort out its syndrome types, syndrome elements, treatment methods and prescriptions by using frequency analysis, constituent ratio analysis and factor analysis. Results： The common syndromes types of type 2 diabetic peripheral neuropathy are Qi vacuity with blood stasis, Qi and Yin vacuity, static blood obstructing the network vessels, phlegm-stasis obstructing the network vessels, Yang vacuity and blood stasis and liver-kidney Yin vacuity. The common disease syndrome elements are blood stasis, Qi vacuity, network vessels, Yin vacuity, phlegm, dampness and Yang vacuity. The common position syndrome elements are network vessels, liver, spleen and kidney. The deficiency syndrome elements are Qi vacuity, Yin vacuity and Yang vacuity. The repletion pattern elements are blood stasis, phlegm, dampness, heat and toxin. The common prescriptions are Huangqi Guizhi Wuwu decoction（黄芪桂枝五物汤）, Danggui Sini decoction（当归四逆汤） and Buyang Huanwu decoction（补阳还五汤）. The common Chinese medicines are Huangqi（astragalus） and Danggui（angelica）. Commonly used drug pairs are Huangqi（astragalus） series and Taoren（peach kernel） series. Conclusion： Type 2 diabetic peripheral neuropathy is a disease of root vacuity and tip repletion and vacuity-repletion complex. The deficiencies are mainly Qi vacuity and Yin vacuity. The tip repletion is mainly blood stasis while others are phlegm, dampness, heat and poison. The position of the disease is in the network vessels, involving the liver, spleen and kidney. Vacuity of Qi and Yin is the basic pathogenesis of type 2 diabetic peripheral neuropathy, and blood stas

关 键 词：2型糖尿病周围神经病变 证型 证素 药对 药串 

分 类 号：R255.4[医药卫生—中医内科学]