基于毒损脉络理论运用解毒通络法治疗糖尿病周围神经病变经验浅析  

Analysis of experience in treating diabetic peripheral neuropathy disease with detoxication and dredging collaterals method based on the theory"Toxin impairs collaterals"

作　　者：姚亚娟 武敏 孙新宇[2] Yao Yajuan;Wu Min;Sun Xinyu

机构地区：[1]河南中医药大学,河南郑州450002 [2]河南省中医院,河南郑州450002

出　　处：《中医临床研究》2021年第12期62-64,共3页Clinical Journal Of Chinese Medicine

摘　　要：糖尿病周围神经病变(Diabetic Peripheral Neuropathy,DPN)作为糖尿病常见的慢性并发症之一,占糖尿病患者的30%~40%,临床多表现为四肢远端皮肤感觉障碍和运动障碍,严重影响患者的生活质量。西医对其发病机制目前尚无定论,治疗主要以降糖、抗氧化、改善循环等对因对症治疗为主,远期疗效欠佳。根据DPN的临床表现可将其归属于中医学理论“消渴痹证”范畴,中医药治疗本病具有独特优势和较好的临床疗效。孙新宇教授从事糖尿病及其并发症的中西医防治临床及科研工作多年,从整体观念和辨证论治的中医思维出发,认为消渴痹证是由于消渴日久不愈,湿浊、痰凝、瘀血等病理产物蕴结成毒,阻于脉络而成。湿浊痰瘀之毒又可作为新的致病因素使疾病缠绵难愈。本病病位以脉络为中心,涉及多脏腑。病性属本虚标实,以气虚、阴虚为本,湿、浊、痰、瘀为标,瘀血则贯穿始终。病机关键是气阴两虚,湿浊、痰瘀阻络。孙教授针对此病机提出毒损脉络理论,并提出解毒通络法应用于临床,可明显改善患者麻木、疼痛等症状,延缓或逆转疾病进展。本文从因、机、证、治,结合医案探讨孙新宇教授解毒通络法治疗DPN的经验及应用,以期为中医治疗本病提供参考。As one of the common chronic complications of diabetes,diabetic peripheral neuropathy occurs in about 30%-40%of the patients with diabetes.Clinically,it is mostly manifested as distal limb skin sensation disorder and movement disorder,which seriously affects the quality of life of the patients.Western medicine has not yet concluded the pathogenesis of the disease,the treatment mainly includes hypoglycemic,antioxidant,improving circulation and other symptomatic treatment,the long-term effect is poor.According to the clinical manifestations of diabetic peripheral neuropathy,it can be classified into the category of TCM theory of"Xiaoke and Bi Syndrome"(消渴痹证),and traditional Chinese medicine(TCM)treatment of this disease has unique advantages and better clinical efficacy.Professor Sun Xinyu has been engaged in the clinical and scientific research of TCM and Western medicine for the prevention and treatment of diabetes and its complications for many years.Based on the overall concept and the TCM thinking based on syndrome differentiation,he believes that"Xiaoke and Bi Syndrome"is formed by the accumulation of toxic pathological products such as dampness,phlegm,blood stasis and so on,which are blocked in the collaterals.The poison of phlegm and blood stasis can be used as a new pathogenic factor to make the disease lingering and difficult to heal.The disease is centered on the collaterals and involves many viscera.The disease belongs to the deficiency of Qi and Yin(气阴),with dampness,turbidity,phlegm and blood stasis as the symptom,and blood stasis running through the whole process.The key pathogenesis is deficiency of Qi and Yin,dampness and turbidity,phlegm and blood stasis.In view of this pathogenesis,Professor Sun proposes the theory of"Toxin impairs collaterals",and puts forward the detoxification and collateralization method to be applied in clinic,which can obviously relieve patients'symptoms such as numbness and pain,and delay or reverse the disease progression.This paper discusses Professor Sun Xin

关 键 词：糖尿病周围神经病变 毒损脉络 毒 络 解毒通络 神^(+) 

分 类 号：R781.64[医药卫生—口腔医学]