黄祥武治疗消渴病痹症用药特点

Characteristics of medication in the treatment of Bi syndrome of diabetes for HUANG Xiangwu

黄祥武主任医师认为,消渴病痹症(糖尿病周围神经病变)的主要证候有阳虚血瘀、气虚血瘀、痰浊阻络、阴虚血瘀,并以阳虚血瘀及气虚血瘀为主。黄老认为,消渴的基本病机为阴津亏损,燥热偏盛,但由于阴阳互根,消渴日久,必定出现阴损及阳,导致阴阳两虚,且以脾肾阳虚较为多见,故脾肾阳虚为消渴病痹症的基本病理基础。治疗上以温补脾肾、培元固本为主;病久入络,血脉瘀滞,或阳气虚弱,无力推动血液运行,出现瘀滞,或阴虚内热,耗伤津液,出现瘀滞,故气滞血瘀是其最关键的病理产物,以行气活血、通络止痛为要;消渴病痹症病程较长,必定是有虚有实,虚实夹杂,在治疗上以扶正祛邪,标本同治为本。用药以当归四逆汤加四君子汤加减。

Doctor HUANG Xiangwu suggests that arthralgia-syndrome of diabetes （diabetic peripheral neuropathy） contain different types, such as blood stasis caused by yang deficiency, blood stasis caused by qi deficiency, obstruction of meridians caused by phlegm, blood stasis and yin deficiency, of which blood stasis caused by yin or yang deficiency is the most important. Dr.HUANG thinks that yin deficiency and dryness-heat are the basic pathogenesis mechanism of consumptive thirst, but with the progress of the disease, dual deficiency of yin and yang will be the final result because yin and yang affect and enrich each other, and yang deficiency of spleen and kidney is the most common type. So we draw a conclusion that we should treat it with warming the yang of spleen and kidney and add vitality because yang deficiency of spleen and kidney is the basic pathology of diabetes disease. Qi stagnation and blood stasis is the most critical pathological product because blood block nowhere with the progress of the disease, or yang is too weak to drive blood to run, or yin deficiency and heat make body fluid dry. Making qi and blood running and smoothing meridian to cure the pain is the most important in the treatment. In the long course of arthralgia-syndrome of diabetes, complicated condition must contain deficiency and superfluous part. So we should add physical ability and quxie with the internal and external treatment at the same time. We always use Chinese medicine decoction of Danggui Sini and Sijunzi.