试述藤类风药在消渴痹证应用中的点睛之处

Application of Rattan Medicine for Treatment of Diabetic Peripheral Neuropathy

消渴痹证由慢性高血糖和微血管病变引起的以"凉、麻、痛、痿"为特点的对称性多神经病变,病机与消渴日久,阴伤气耗,正虚邪恋,久病入络、瘀血阻滞有关,而阴虚、血瘀、糖毒皆能化生风邪,治疗时应在益气活血、化瘀通络法(或中药)的基础上加上治"风"药。但消渴痹证为顽疾,非一般治"风"药可达,结合络脉学说、脉络-血管系统病的同一性及取象比类思维,引入"凡藤蔓之属,皆可通经入络,善治风疾"的藤类风药治疗消渴痹证,临床效果独特。一则作为引经药,引药物直达脉络;一则加强祛风通络止痛之功,实为点睛之处。

Diabetic peripheral neuropathy is characterized by numbness,pain,muscular atrophyand cold.The pathogenesis of western medicine is chronic hyperglycemia and microangiopathy,and Chinese medicine is related to chronic diabetes,Qi and fluid consumption,decreased body resistance,disease entered into meridians,and blood stasis.Yin deficiency,blood stasis and sugar poison can produce wind evil.It is necessary to add rattan medicine on the basis of promoting Qi and activating blood,removing blood stasis and dredging collaterals.Combined with the theory of collaterals,the identity of collaterals-vascular system and the thinking of analogy,the rattan medicine is introduced to treat diabetic peripheral neuropathy and has a unique clinical effect.