金杰从湿热辨治末梢神经炎  

JIN Jie Differentiating Peripheral Neuritis from Dampness and Heat

作　　者：唐小笛 李相儒 金杰[1] TANG Xiaodi;LI Xiangru;JIN Jie(Henan University of TCM,Zhengzhou 450000,Henan,China;The First Affiliated Hospital of Henan University of TCM,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学,河南郑州450000 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《实用中医内科杂志》2020年第3期4-6,共3页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家中医药管理局第四批全国中医(临床、基础)优秀人才研修项目资助(201712);河南省中医药管理局基金资助项目(2013ZY02028)。

摘　　要：末梢神经炎(多发性神经病)是临床常见的一种周围性神经疾病,以四肢末梢皮肤感觉异常为主要特点,患肢远端呈戴手套、短袜型感觉减退,或针刺、麻木、灼热感、蚁行感、烧灼、感觉过敏等刺激症状,甚则出现肌肉萎缩,更甚者会导致瘫痪。现代医学研究表明,感染、免疫、炎性、中毒、营养代谢障碍等均可引起末梢神经的损害,但对不明原因致病者,从临床常规治疗方案,给予营养神经、改善循环、减轻疼痛等对症治疗,效果往往欠佳。中医对该病的认识历时已久,金杰教授经过多年的临床研究和总结,认为末梢神经炎属中医"痹证"范畴,发病过程多与肝、脾、肾等脏腑功能相关,病机的本质为本虚标实,以气血亏虚为本,湿热为标。治疗当以清热利湿,通筋利痹兼补益气血。脾胃为后天之本,气血生化之源,补益气血当从脾胃入手,兼顾它脏。临床上应用加味四妙以清热祛湿,宣痹祛邪,活血通络,后期配合四君子加减治疗末梢神经炎,临床疗效显著。现代药理研究,加味四妙中的多味药物均具有抗炎抗菌、免疫调节、止痛的作用,为加味四妙治疗末梢神经炎提供了依据。疾病的治疗是一个重要的方面,但本病具有复发性,后期预防调护和健康的生活方式管理在预防该病中也发挥着重要的作用。Peripheral neuritis (polyneuropathy) is a common clinical neurological disease,with the abnormal feeling of limb peripheral skin as the main characteristics.The distal limb’s feeling is like wearing gloves or socks,or sensory irritation symptoms like numbness,burning,ant line feeling,or even muscle atrophy,moreover paralysis.Modern medical research shows that infection,immunity,inflammation,poisoning,nutritional metabolic disorder and so an can cause peripheral nerve damage.But due to the unknown causes of the disease,the clinical routine treatment programs,giving nutritional nerve,improving circulation,reducing pain and other symptomatic treatments often have poor effect.The understanding of the disease in traditional Chinese medicine has been a long time.Professor JIN Jie,after years of clinical research and summary,believes that peripheral neuritis belongs to Bi syndrome in Traditional Chinese Medicine.The pathogenesis is mainly related to the liver,spleen,kidney and other viscera functions.The treatment should be to clear heat and eliminate dampness,smooth energy channel and tonify Qi and blood.Spleen and stomach is the source of acquired constitution and the source of Qi and blood.Clinical application of modified Simiao Formula can clear heat and eliminate dampness,remove obstruction and activate blood circulation.And then the treatment combined with Sijunzi Formula has significant clinical effect.In the modern pharmacological research,the multi-flavor drugs in modified Simiao Formula all have the functions of anti-inflammation,anti-bacteria,immune regulation and analgesia,providing the basis for modified Simiao Formula to treat peripheral neuritis.The treatment of the disease is an important aspect,but the disease has a certain recurrent characteristics.Later prevention and care and healthy lifestyle management in the prevention of the disease also play an important role.

关 键 词：末梢神经炎 湿热 祛湿通络 加味四妙 痹证 名中医经验 金杰 预防调护 

分 类 号：R249[医药卫生—中医临床基础]