陈志刚教授辨病论治周围神经病经验

Pro. CHEN Zhi-gang′s experience in treating peripheral neuropathy based on disease differentiation

周围神经病的病因复杂、病程不一、临床表现多样。陈志刚教授提出根据周围神经病西医分类,针对不同的病程、病因"辨病论治"。急性/亚急性周围神经病与感受外邪有关,治疗当以祛外邪为主,并强调补益气血;慢性周围神经病应从内伤、积损角度考虑,需根据上中下三焦辨证确定问题所在,治疗上除着重气血问题外,应适当加用补肾药物;复发性周围神经病需从"伏邪理论"角度认识,核心病机是正气虚衰、脏腑失调而致痰浊毒瘀内生,治疗当以"益气扶正,化浊解毒"为法。

Peripheral neuropathy disease have complex etiologies,various courses and diverse clinical manifestations.Disease differentiation treatment is proposed by professor CHEN Zhi-gang,which is based on different courses and etiologies according to the classification of peripheral neuropathy in western medicine.Acute/subacute peripheral neuropathy is associated with exogenous pathogens,and removing pathogens is considered to be the primary treatment,supplementing qi and blood should be emphasized.Chronic peripheral neuropathy should be considered in terms of internal and accumulated damages.It is necessary to identify the problem according to syndrome differentiation of sanjiao theory.In addition to emphasizing qi and blood,invigorating kidney drugs should be properly used.The recurrent peripheral neuropathy needs to be understood from the perspective of ＂hidden pathogen theory＂.Its core pathogenesis is deficiency of vital qi,disorder of zang and fu viscera generating turbid phlegm,toxin and stasis.Treatment should be ＂benefiting vital qi,resolving phlegm and removing toxicity＂.