张玉琴教授治疗糖尿病周围神经病变经验总结
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摘要
本文主要介绍全国名老中医药专家张玉琴教授治疗糖尿病周围神经病变(DPN)的临床经验。张玉琴教授认为气虚血瘀是DPN发病的基本病机,其特征为本虚标实,以气虚为本,气虚体现在肺、胃(脾)、肾气虚之别,瘀血为标,瘀血虽为病理产物,发展到本病之时已然成为了致病因素。治疗上张玉琴教授提出当以益气活血、化瘀通络为治则,临床多以自拟糖痹康加减化裁口服,配合糖痛外洗方和糖痹外洗方行中药熏洗,改善了DPN患者以疼痛麻木为主的临床症状,提高了临床疗效。
This paper introduces mainly the clinical experience of professor ZHANG Yu-qin as a famous veteran expert of traditional Chinese medicine treating diabetic peripheral neuropathy(DPN). Professor ZHANG Yu-qin thinks that qi deficiency and blood stasis is the basic pathogenesis of DPN, which is characterized by deficiency in origin and excess in superficiality taking qi deficiency as the origin and qi deficiency is reflected in the difference between lung,stomach(spleen) and kidney qi deficiency, while blood stasis is the superficiality. Although blood stasis is a pathological product, it has become a pathogenic factor when it develops into the disease. In the treatment, professor ZHANG Yu-qin puts forward the treatment principle of invigorating qi and activating blood circulation, removing blood stasis and dredging collaterals. In clinical practice, self-made Tangbikang for plusing and subtraction for oral administration,combined with Tangtong external wash and Tangbi external wash conducting the herbal fumigation, and it improves the main clinical symptoms of pain numbness in DPN patients, and improvs the clinical efficacy.
This paper introduces mainly the clinical experience of professor ZHANG Yu-qin as a famous veteran expert of traditional Chinese medicine treating diabetic peripheral neuropathy(DPN). Professor ZHANG Yu-qin thinks that qi deficiency and blood stasis is the basic pathogenesis of DPN, which is characterized by deficiency in origin and excess in superficiality taking qi deficiency as the origin and qi deficiency is reflected in the difference between lung,stomach(spleen) and kidney qi deficiency, while blood stasis is the superficiality. Although blood stasis is a pathological product, it has become a pathogenic factor when it develops into the disease. In the treatment, professor ZHANG Yu-qin puts forward the treatment principle of invigorating qi and activating blood circulation, removing blood stasis and dredging collaterals. In clinical practice, self-made Tangbikang for plusing and subtraction for oral administration,combined with Tangtong external wash and Tangbi external wash conducting the herbal fumigation, and it improves the main clinical symptoms of pain numbness in DPN patients, and improvs the clinical efficacy.
引文
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[10]朗宁,余杰,文俊.加味黄芪桂枝五物汤治疗糖尿病周围神经病变82例临床观察[J].中国实用神经疾病杂志,2015,18(20):14-16.
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[13]张磊.中药熏洗联合西药治疗糖尿病周围神经病变疗效的系统评价[J].护理学报.2015,22(12):36-43.
[14]何宏涛.丹参注射液联合甲钴胺治疗糖尿病神经病变疗效观察[J].现代诊断与治疗,2014,25(22):5062-5063.
[15]李莉,王旭.糖尿病周围神经病变的中医药治疗研究[J].吉林中医药,2011,31(4):310-312.
[16]孙海青.磁圆梅针循经叩刺治疗糖尿病周围神经病变疗效观察[J].山西中医学院学报,2012,13(5):55.
[17]梁丽芳,卜晓宏,吴桂清,等.益气通络方联合格列齐特治疗2型糖尿病性周围神经病变的临床观察[J].中医药信息,2016,33(4):87-89.
[18]张宏颖,苏海玉,王永锟,等.尼莫地平联合芪明颗粒治疗糖尿病周围神经病变的临床疗效观察[J].中医药信息,2016,33(6):97-100.
[19]李崖雪,闫建华,王丰,等.针刺六经原穴(阴经输穴)治疗糖尿病周围神经病变患者的临床疗效观[J].中医药学报,2015,43(5):24-26.
[20]赵丽,何辉.当归四逆汤联合中药足浴对糖尿病周围神经病变的效果研究[J].中医药学报,2015,43(3):118-120.
[2]方朝晖,吴以岭,赵进东.糖尿病周围神经病变中医临床诊疗指南(2016年版)[J].中医杂志,2017,58(7):625-630.
[3]Jose Marin-Penalver J,Martin-Timon I,Sevillano-Collantes C,et al.Update on the treatment of type 2 diabetes mellitus[J].World J Diabetes,2016,7(17):354-395.
[4]胡智,朱哲宇,李勇,等.糖尿病周围神经病变发病机制及治疗研究进展[J].人民军医,2017,60(4):409-411.
[5]王雷,陈晓雯.糖尿病周围神经病变的中医研究进展[J].黑龙江中医药,2012,18(4):60-61.
[6]庞国明,闫镛,朱璞,等.糖尿病周围神经病变中医诊疗规范初稿[J].中华中医药杂志,2010,25(2):260-264.
[7]苗桂珍,梁秀珍,王亚红.补气活血法治疗糖尿病周围神经病变的临床观察[J].中国中西医结合杂志,2003,23(11):826-828.
[8]程红卫,秦艳.胡筱娟主任医师治疗消渴病痹病的经验总结[J].现代中西医结合杂志,2017,26(33):3747-3749.
[9]胡月,刘怀珍,刘妙珠,等.加减黄芪桂枝五物汤治疗气虚血瘀型糖尿病周围神经病变临床观察[J].中医药临床杂志,2018,30(1):105-108.
[10]朗宁,余杰,文俊.加味黄芪桂枝五物汤治疗糖尿病周围神经病变82例临床观察[J].中国实用神经疾病杂志,2015,18(20):14-16.
[11]刘长青.加味黄芪桂枝五物汤治疗糖尿病神经病变40例临床观察[J].天津中医药,2016,33(9):536-537.
[12]鲁铭,李少英,章莉.中药沐足治疗护理糖尿病周围神经病变[J].湖北中医杂志.2009,31(3):44-45.
[13]张磊.中药熏洗联合西药治疗糖尿病周围神经病变疗效的系统评价[J].护理学报.2015,22(12):36-43.
[14]何宏涛.丹参注射液联合甲钴胺治疗糖尿病神经病变疗效观察[J].现代诊断与治疗,2014,25(22):5062-5063.
[15]李莉,王旭.糖尿病周围神经病变的中医药治疗研究[J].吉林中医药,2011,31(4):310-312.
[16]孙海青.磁圆梅针循经叩刺治疗糖尿病周围神经病变疗效观察[J].山西中医学院学报,2012,13(5):55.
[17]梁丽芳,卜晓宏,吴桂清,等.益气通络方联合格列齐特治疗2型糖尿病性周围神经病变的临床观察[J].中医药信息,2016,33(4):87-89.
[18]张宏颖,苏海玉,王永锟,等.尼莫地平联合芪明颗粒治疗糖尿病周围神经病变的临床疗效观察[J].中医药信息,2016,33(6):97-100.
[19]李崖雪,闫建华,王丰,等.针刺六经原穴(阴经输穴)治疗糖尿病周围神经病变患者的临床疗效观[J].中医药学报,2015,43(5):24-26.
[20]赵丽,何辉.当归四逆汤联合中药足浴对糖尿病周围神经病变的效果研究[J].中医药学报,2015,43(3):118-120.