传统疡科视角下的糖尿病足与筋疽新论  

Novel perspective on diabetic foot and Jin gangrene from the standpoint of traditional Chinese medicine surgery

作　　者：殷康力 曹烨民 YIN Kangli;CAO Yemin(Shanghai University of Traditional Chinese Medicine,Shanghai 200086,China;Shanghai TCM-Integrated Hospital,Shanghai University of TCM,Shanghai 200082,China)

机构地区：[1]上海中医药大学,上海200086 [2]上海中医药大学附属上海市中西医结合医院,上海200082

出　　处：《中华中医药杂志》2024年第7期3349-3353,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：全国基层名老中医药专家曹烨民传承工作室建设项目(No.Z155080000004);上海市名老中医学术经验工作室建设项目(No.SHGZS-202248);上海市卫生健康委员会中医药标准化项目(No.2023JS07);上海市虹口区卫生健康委员会中医药科研课题(No.HKQGYQY-ZYY-2022-05);上海市虹口区卫生健康委员会第二轮国医强优建设项目(No.HKGYQYXM-2022-07,No.HKGYQYXM-2022-30)。

摘　　要：文章在中医外科学经典基础上,探讨糖尿病足的中医病名病类。根据疡科经典与病症特征,将消渴脚部疔疮细分为脱疽类与脚发类,旨在丰富糖尿病足的中医辨病论治理论。根据消渴脚部疔疮的文献描述,论证造成脱疽类与脚发类病症差异的核心原因,以脏腑蓄毒,筋膜受病,发为疽证作为消渴脚发类的核心特征,并基于此探讨使用筋疽替代消渴脚发类,作为非缺血型糖尿病足中医病名的合理性。文章以脱疽脚发二分类法,试图解决当下糖尿病足中医病名争议,通过结合医史文献、理论研究及临床实践,为筋疽作为糖尿病足新名称提供更多的理论支持。Based on the classic foundation of traditional Chinese medicine(TCM)surgery,this article discusses the TCM diagnosis and disease classification of diabetic foot(DF).According to the classic literature of ulcer disease and the characteristics of symptoms,diabetes with foot complications is subdivided into Tuo gangrene and foot erysipelas.The aim is to enrich the theory of TCM disease differentiation and treatment of DF.According to the literature description of diabetes with foot complications,the core reasons for the difference between Tuo gangrene and foot erysipelas are discussed,and the core characteristics of foot erysipelas in diabetes are characterized by organ toxicity,fascia disease,and the formation of carbuncle.Based on this,the rationality of using Jin gangrene to replace foot erysipelas in non-ischemic DF as the TCM diagnosis is discussed.This article attempts to leverage the current debate on the TCM name of DF with the two classifications of Tuo gangrene and Jin gangrene,and provides more theoretical support for Jin gangrene as the new name for DF by combining medical history literature,theoretical research and clinical practice.

关 键 词：糖尿病足 消渴脚部疔疮 筋疽 脱疽 辨病论治 中医病名 中医外科学 

分 类 号：R259[医药卫生—中西医结合]