庞鹤应用解毒法治疗湿热毒邪相关糖尿病足  

Pang He′s Application of Detoxification Method in Treating Diabetic Foot Related to Dampness-Heat Toxicity

作　　者：袁文雯 陈小均[1] 金潇[1] 徐孟娇 张凡帆[1] YUAN Wenwen;CHEN Xiaojun;JIN Xiao;XU Mengjiao;ZHANG Fanfan(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing China 100078;Beijing University of Chinese Medicine,Beijing China 100029)

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,北京100029

出　　处：《中医学报》2023年第8期1706-1711,共6页Acta Chinese Medicine

基　　金：第七批全国老中医专家传承项目(040103005002028);全国名老中医传承工作室建设项目{国中医药人教发〔2014〕20号};北京中医药大学基本科研业务费青年教师项目(2019-JYB-JS-150);北京市科委首都市民健康培育项目(Z151100003915132)。

摘　　要：糖尿病足的核心病机为气阴两虚、血瘀、浊邪化毒阻络,而湿热毒邪因其组成复杂,可根据湿热偏重化繁为简,大致分为湿重于热、湿热并重、热重于湿三型,分别以祛湿为主、湿热并治、解毒为主。临证应益气养阴活血不忘解毒,祛邪解毒的同时补虚扶正顾护正气。在应用解毒法治疗湿热毒邪相关糖尿病足时主张整体辨证与局部辨证结合、内外兼治。针对湿热毒邪相关的糖尿病足辨别湿热比重并加以辨证论治,常用黄芪桂枝五物汤加减以益气温经、活血通络、调和气血阴阳,同时应用五苓散、甘露消毒丹、黄连解毒汤、二妙散、四妙勇安汤或犀角地黄汤等祛除湿热毒邪。The core pathogenesis of diabetic foot is deficiency of Qi and Yin,blood stasis as well as turbidness and toxin evil factors blocking collaterals.Due to the complex composition of Dampness-Heat toxin,it can be simplified and divided into three types:Dampness being more serious than Heat,balanced Dampness and Heat as well as Heat being more serious than Dampness,respectively,according to the degree of the both.The methods would be mainly dispelling Dampness,balanced Dampness-Heat treatment and mainly detoxification in clinics.Therefore,tonifying Qi and Yin as well as activating blood circulation can be used with detoxification,or detoxification with tonifying deficiency and protecting Zheng Qi.It is recommended to combine holistic syndrome differentiation with local syndrome differentiation in internal and external treatment.By distinguishing the proportion of Dampness-Heat in diabetic feet related to Dampness-Heat toxicity according to different syndromes,modified Wuling Powder,Ganlu Sanixia Dan,Huanglian Jiedu Decoction,Ermiao Powder,Simiao Yong′an Decoction or Xijiao Dihuang Decoction are often used to remove Dampness-Heat toxic evil factor based on the modified Huangqi Guizhi Wuwu Decoction,which can tonify Qi,warm meridians and harmonize Yin and Yang,so as to remove the Dampness-Heat evil factors.

关 键 词：糖尿病足 湿热毒邪 解毒法 庞鹤 

分 类 号：R249.27[医药卫生—中医临床基础]