“脾主运化”及肝-肾-肺与糖尿病周围神经病变

Treatment of Diabetic Peripheral Neuropathy with The Principle of “Spleen Governing Movement”

糖尿病周围神经病变(DPN)是脾失健运,脾气亏虚贯穿于疾病始终,痰瘀为标,不同发展阶段各有侧重。临证应根据病史长短、邪正盛衰以及伴随症状,以辨虚实,虚有气虚、阴虚、阳虚之别,实有瘀血、痰浊之异,以虚实夹杂最为常见。肝气郁结,化热伤津可致消渴,情志抑郁,肝失疏泄,肝气郁结,气滞血瘀,脉络不通,故四肢疼痛。病变脏腑主要在肺、胃、肾,尤以肾为关键。脾主运化在DPN发生、发展过程中处核心地位,亦不可忽视肝、肾、肺等脏腑。脾失健运,气阴两虚,必及于肾,且肾内寓元阴元阳,滋其阴则上润肺胃,壮其阳则助脾运化。

Diabetic peripheral neupathy is a disease of the spleen lost health, spleen and spleen deficiency runs through the disease, phlegm and blood stasis as the standard. Liver qi stagnation, heat injury of Tianjin can cause diabetes, depression and emotional catharsis liver failure, liver qi stagnation, qi stagnation and blood stasis and context impassability. Therefore, pain in the limbs. Pathological changes in the lungs, stomach, kidney, especially in the kidney as the key. Spleen, deficiency of Qi and Yin, will in the kidney and renal inside contain Yuan Yin Yuanyang, nourishing Yin, lungs and stomach, Zhuang Yang is to help and spleen. From the perspective of ＂spleen transport＂ discusses the DPN etiology, pathogenesis and therapeutic principle, provide a theoretical basis for the prevention and treatment of traditional Chinese medicine DPN.