从络病探讨糖尿病性脑血管病的辨治思路

Clinical thinking of the treatment of diabetic cerebrovascular disease based on collateral disease

糖尿病性脑血管病是糖尿病的常见并发症之一。络病是广泛存在于糖尿病慢性并发症中的病理状态,也是糖尿病性脑血管病的重要病理机制。糖尿病性脑血管病的基本病机为肝肾气阴亏虚,风、火、痰、瘀血阻滞脑络,基本病理环节为络气虚滞、络脉瘀阻、络脉拙急、络脉瘀塞、络脉瘀结。从审证求因、通补结合,善用虫蚁、祛邪通络,滋补肝肾、重视气血,起居调摄、防治结合等方面对治疗方法进行阐述,以探讨糖尿病性脑血管病的辨治思路。

Diabetic cerebrovascular disease is one of the common complications of diabetes. The collateral disease is widely existed in the diabetic chronic complications. It is the important pathological mechanism of diabetic cerebrovascular disease. The basic pathogenesis is qi and yin deficiency in liver and kidney and with wind,fire,phlegm,blood stasis blocking the brain collateral. The basic pathological processes are qi deficiency of collaterals,the blood stasis resistance in the brain collateral,contraction of the brain collateral,blood stasis in brain collateral. To discuss the ideas about syndrome differentiation and treatment of diabetic cerebrovascular disease,the following points are set forth. The determination of etiologic factors should be based on differentiation. The reinforcing method and reducing method are combined together. The insect drugs should be made the most of to eliminate pathogens and drege collaterals.It is very important to nourish the liver and kidney and tonify qi and blood. Diabetic cerebrovascular could be prevented by lifestyle measures,such as diet and exercise,or medication.