基于玄府理论探讨痛性糖尿病周围神经病变的中医证治  

Exploring the Treatment of Painful Diabetic Peripheral Neuropathy with TraditionalChinese Medicine Based on the Theory of Mysterious Orifices

作　　者：李芷仪 冷锦红[2] LI Zhiyi;LENG Jinhon(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《实用中医内科杂志》2025年第3期26-29,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：张静生国医大师传承工作室建设项目(2022-304);辽宁省教育厅高等学校基本科研项目(LJKMZ20221332);沈阳市科技计划项目(22-321-33-39)。

摘　　要：《黄帝内经》最早提出了玄府,后经刘完素创新发展后提出“玄府理论”,阐述了玄府并非只是狭义上的汗孔,而是遍及周身,无物不有的细微结构,是气血津液运行升降的通道。痛性糖尿病周围神经病变(painful diabetic peripheral neuropathy,PDPN)在中医上归属于消渴痹症,外感六淫,七情内伤,运化失司,酿生痰瘀,玄府郁闭,气血亏虚,基于玄府理论,通过分析PDPN的病因病机,认为应从补虚扶正以固玄,行气化痰,活血化瘀以开玄论治,内外相结合,针药相结合,标本兼治,攻补兼施,在玄府理论的指导下以通利玄府为主要方法,为临床治疗PDPN提供思路。The concept of the"mysterious orifices"(xuanfu)was first introduced in the"Huangdi Neijing"(The Yellow Emperors Classic of Medicine)and was later innovatively developed by Liu Wan Su into the"Theory of Mysterious Orifices."This theory elaborates that the mysterious orifices are not merely the narrow concept of sweat pores but are subtle structures spread throughout the body,omnipresent,and serve as channels for the movement,ascent,and descent of qi,blood,and body fluids.Painful diabetic peripheral neuropathy(PDPN)is classified in Traditional Chinese Medicine(TCM)as a type of thirst-wasting and numb syndrome,caused by external pathogenic factors,emotional disturbances,dysfunction in transformation and transportation processes,leading to phlegm and blood stasis,obstruction of the mysterious orifices,and deficiency in qi and blood.Based on the Theory of Mysterious Orifices,by analyzing the etiology and mechanism of PDPN,it is proposed to treat the condition by nourishing deficiency and supporting the right to consolidate the mysterious,promoting qi movement and phlegm dissolution,activating blood circulation and removing blood stasis to open the mysterious orifices.This approach integrates internal and external treatments,combines acupuncture with medication,addresses both symptoms and root causes,and employs both attacking and supporting strategies.Guided by the Theory of Mysterious Orifices,the primary method focuses on unblocking the mysterious orifices,providing insights for the clinical treatment of PDPN.

关 键 词：玄府 糖尿病周围神经病变 玄府理论 刘完素 糖尿病 

分 类 号：R255.4[医药卫生—中医内科学]