日本汉方治疗糖尿病慢性并发症研究概况  

A Survey of the Study on the Treatment of Chronic Complications of Diabetes with Japanese Kampo Medicines

作　　者：李梦丹[1] 郭利平[1] 任明[2] 李弘扬 郝志婧 金柯廷 LI Meng-dan;GUO Li-ping;REN Ming;LI Hong-yang;HAO Zhi-jing;JIN Ke-ting(Tianjin University of TCM,Tianjin,China,300300;Baokang Hospital Affiliated to Tianjin University of TCM,Tianjin,China,300193;Kanazawa University,Kanazawa,Japan,9208640)

机构地区：[1]天津中医药大学,天津300300 [2]天津中医药大学附属保康医院,天津300193 [3]日本金泽大学,日本金泽9208640

出　　处：《河南中医》2020年第6期951-955,共5页Henan Traditional Chinese Medicine

基　　金：天津市科技计划项目(15ZXLCSY00020);教育部“创新团队发展计划”项目(IRT_16R54)。

摘　　要：日本在20世纪末提出大部分糖尿病都不是"消渴",认为症状上可以称之为"消渴"的糖尿病,实际上已经到了糖尿病并发症时期,采用西医进行血糖管理不再容易,到了"消渴"这一步,在改善症状方面,相比现代医学,汉方治疗是更为主要的治疗手段。发病原因不同的糖尿病中医证型不同,肥胖为发病原因的多表现为实热证。日本汉方治疗糖尿病并发症的常用处方包括糖尿病肾病常用方剂、糖尿病神经功能障碍常用方剂、糖尿病下肢血管病变常用方剂等,其中糖尿病肾病常用方剂主要包括八味地黄丸和柴苓汤;糖尿病神经功能障碍常用方剂包括牛车肾气丸、舒经活络汤、桂枝加术附汤、抑肝散、加味逍遥散、人参养荣汤等;糖尿病下肢血管病变包括下肢动脉病变和糖尿病足,下肢动脉病变的常用方剂为归芪建中汤,糖尿病足的常用方剂为归芪建中汤加附子。日本汉方的研究模式和发展现状能为我们提供一些思路和借鉴,但多以小样本自主研究为主,一般规律及用单味药的作用机制阐述整个中药复方的功能并不完整,掩盖了复方整体的功能性,在临床应用上也不能彰显其用药的灵活性。今后,应加强治疗糖尿病并发症中医药的系统研究。At the end of the 20 th century,Japan put forward that most of the diabetes mellitus is not"wasting thirst"in terms of symptoms.In fact,it has reached the stage of diabetic complications.It is no longer easy to use western medicine to manage blood sugar.In the step of"wasting thirst",in terms of improving symptoms,compared with modern medicine,using Kampo Medicines is the main treatment.The TCM syndrome types of diabetes mellitus are different due to different causes of disease.Obesity is manifested as excess heat syndrome.The commonly used prescriptions for diabetic complications with Japanese Kampo Medicines include common prescriptions for diabetic nephropathy,the ones for diabetic nerve dysfunction,the ones for diabetic lower extremity vascular diseases,etc.The common prescriptions of diabetic nephropathy mainly include Eight-Ingredient Rehmannia Pill,Bupleurum and Poria Decoction.The ones for diabetic nerve dysfunction include Niu Che Shen Qi Pill(牛车肾气丸,NCSQP),Decoction for Relieving Meridians and Activating Channels,Cinnamon Twig Decoction plus Rhizoma Atractylodis Macrocephalae and Poria,Liver-Restraining Powder,Supplemented Free Wanderer Powder,Ginseng Supporting and Nourishing Decoction,etc.Diabetic lower extremity vascular disease includes lower extremity artery disease and diabetic foot.Radix Angelicae Sinensis and Radix Astragali Center-Strengthening Decoction is commonly used for lower extremity artery disease,and Radix Angelicae Sinensis and Radix Astragali Center-Strengthening Decoction plus Poria is commonly used for diabetic foot.The research mode and development status of Japanese Kampo Medicines can provide us with some ideas and references,but most of them are based on small samples of independent research.The general rules and the mechanism of action of single drug explaining the function of the whole TCM compound is not complete,covering up the overall functionality of the compound,and cannot show its flexibility in clinical application.So in the future,we should strengthen the sys

关 键 词：糖尿病并发症 日本汉方 糖尿病肾病 糖尿病神经功能障碍 糖尿病下肢血管病变 八味地黄丸 柴苓汤 牛车肾气丸 

分 类 号：R259[医药卫生—中西医结合]