基于“虚气流滞”理论从络病论治痛性糖尿病周围神经病变  

Discussion on the Treatment of Painful Diabetic Peripheral Neuropathy Based on the Theory of“Deficient-qi Induced Stagnation”from the Perspective of Collateral Disease

作　　者：彭幽 崔崇嵩 荆雅楠 张雅琪 周映伶 张航 刘振杰[1,4] PENG You;CUI Chongsong;JING Yanan;ZHANG Yaqi;ZHOU Yingling;ZHANG Hang;LIU Zhenjie(The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine,Guangdong Pharmaceutical University(Institute of Chinese Medicine),Guangzhou 510006,China;Key Laboratory of Glucolipid Metabolic Disorder,Ministry of Education,Guangzhou 510006,China;Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广东药科大学广东省代谢病中西医结合研究中心(中医药研究所),广东广州510006 [3]糖脂代谢病教育部重点实验室,广东广州510006 [4]广东省中医院,广东广州510120

出　　处：《中国中医药信息杂志》2025年第3期161-166,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家重点研发计划(2018YFC2002500);广东省大学生创新创业训练计划(202210572060);广东省中医院中医药科学技术专项(YN2022MS15)。

摘　　要：痛性糖尿病周围神经病变(PDPN)发病机制复杂,治疗棘手,严重影响患者身心健康。中医药治疗PDPN具有一定优势,但缺乏以病机为核心的理论指导。PDPN病机动态演变过程契合“虚气流滞”病机理论。PDPN以疼痛为主症,久痛入络,本文在络病基础上,从“虚气流滞”理论探讨PDPN的病机演变,其中“虚气”主要责之于气血阴阳亏虚,络脉不荣;“流滞”包括气血津液运行失常引起的气滞、痰凝、瘀阻的病理状态,络脉不通。“虚气”与“流滞”相互影响,共同导致PDPN进展。总结其论治思路重点在于调补虚气(补虚)与行滞通络(通滞),为PDPN的临床辨治提供新的诊疗思路与理论依据。The pathogenesis of painful diabetic peripheral neuropathy(PDPN)is very complicated and tricky treat,which seriously affects the physical and mental health of patients.TCM has certain advantages in treating PDPN,but lacks theoretical guidance centered on pathogenesis.The dynamic evolution of the pathogenesis of PDPN fits the theory of“deficient-qi induced stagnation”.PDPN is mainly characterized by pain,with prolonged pain entering the collaterals.This article discussed the pathogenesis of PDPN from the theory of“deficient-qi induced stagnation”based on collateral disease.Among them,the“deficient qi”is mainly responsible for the deficiency of qi,blood,yin and yang,and the collaterals are not be nourished;“stagnation”includes the pathological state of qi stagnation,phlegm and stasis caused by the abnormal movement of qi,blood and body fluid,and the obstruction of collaterals.“Deficient qi”and“stagnation”interact with each other to promote the progress of PDPN.The article concluded that the key point of treatment is to regulate the deficiency qi(tonify deficiency)and remove stagnation and clear collaterals(smooth the stagnation),which could provide a new diagnosis and treatment idea and theoretical basis for the clinical differentiation and treatment of PDPN.

关 键 词：虚气流滞 络病 痛性糖尿病周围神经病变 补虚通滞 消渴痛痹方 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]