从气血理论探讨糖尿病高危足的中医治疗  

Discussion on TCM treatment of Wagner Grade 0 diabetic foot based on qi and blood theory

作　　者：王前 李沛瑾 刘丽星 付常庚 顾汉程[1] 樊炜静 杨宝钟[1] WANG Qian;LI Peijin;LIU Lixing;FU Changgeng;GU Hancheng;FAN Weijing;YANG Baozhong(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078;Dongzhimen Hospital,Beijing University of Chinese Medicine;Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College;Shuguang Hospital of Shanghai University of Traditional Chinese Medicine)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医药大学东直门医院 [3]中国医学科学院肿瘤医院 [4]上海中医药大学曙光医院

出　　处：《现代中医临床》2022年第3期48-51,共4页Modern Chinese Clinical Medicine

基　　金：北京市自然科学基金资助项目(No.7122203);北京市科技计划课题(No.Z151100003915132)。

摘　　要：糖尿病高危足被认为是糖尿病足的早期状态,是指糖尿病患者尚未出现足部溃疡,但已有糖尿病周围神经病变和(或)周围血管病变。中医学认为气血不和是糖尿病高危足发生的关键环节,其病因病机包括:气血两亏,阴损及阳,以虚为本;气滞血瘀,经脉不通,以实为标;卫气失司,营血失和,易感外邪;外邪侵袭,气血亏虚,加重病情。治疗该病的关键为调整气血、平衡阴阳,益气补血、调和阴阳以治本;行气活血、化瘀通络以治标;素体亏虚、不耐攻伐需扶正祛邪。A Wagner Grade 0 diabetic foot is the early stage of the condition,which suggests that the patient develops diabetic peripheral neuropathy and/or peripheral vascular disease without foot ulcers.TCM theories believe that“disharmony of qi and blood”is the root of Wagner Grade 0 diabetic feet.Its etiology and pathomechanism include:qi and blood depletion,yin impairment affecting yang,deficiency as the root;qi stagnation and blood stasis,blockage of meridians,excess as the branch;weakness of wei qi,disharmony of ying-blood,and subsequent susceptibility to exogenous pathogens;external invasion,worsening deficiency of qi and blood,which aggravates the disease.The key to the treatment is to treat the root by regulating qi and blood,balancing yin and yang,boosting qi and supplementing blood,to treat the branch by moving qi and invigorating blood,dissolving stasis and dredge collaterals,and,for those significantly weakened by the disease and thus unable to withstand the power of the medications,to reinforce healthy qi before dispelling evil.

关 键 词：气血理论 糖尿病高危足 糖尿病周围神经病变 糖尿病周围血管病变 理论探讨 

分 类 号：R261[医药卫生—中医外科学]