基于《黄帝内经》营卫理论探讨不安腿综合征

Exploration of Restless Legs Syndrome Based on Nutrient-defense Theory of Inner Canon of Huangdi

基于《黄帝内经》(《内经》)理论,分析不安腿综合征的临床特点,认为本病与中医学肉苛、肉烁、足悗等病证有关;运用营卫运行节律分析,本病基本病机为营卫失和,气血不调;其病位在筋肉,故责之肝脾不调。不安腿综合征病因复杂,病情迁延难愈,符合《内经》“因加而发,合邪为患”的发病观,即外感风寒湿邪,内有营卫气血失和与肝脾功能失调,外内合邪而为病。结合经典理论与临床相关文献,将不安腿综合征归纳为外邪侵袭、营卫不和,肝郁气滞、瘀血阻脉,阴血不足、筋脉失养,脾失健运、湿热下注,脾不升清、阳气不足五个基本证型,以黄芪桂枝五物汤、血府逐瘀汤、芍药甘草汤及归脾汤等方药加减辨治。

Based on the theory of Inner Canon of Huangdi,this paper analyzed the clinical characteristics of restless legs syndrome,and held that it is related to the diseases and syndromes of traditional Chinese medicine,such as“rouke”,“roushuo”,“zuman”.By using the movement rhythm analysis of nutrient-defense,the basic pathogenesis of this disease is nutrient-defense disharmony and disharmony of qi and blood.The disease location is in muscles and tendons,so it is attributed to liver-spleen disharmony.The etiology of restless leg syndrome is complex,and it is difficult to recover.It is in line with the pathogenesis view of“disease will occur due to interior changes complicated by the exterior influence”,i.e.exogenous wind,cold and dampness pathogens,internal disharmony of nutrient,defense,qi and blood,liver-spleen disharmony,internal and external combined pathogens causing diseases.Combined with the classical theory and clinical literature,this paper summarized restless legs syndrome into five basic syndrome types:invasion of external pathogenic factors,disharmony of nutrient-defense;liver depression and qi stagnation,blood stasis obstructing vessels;insufficiency of yin blood,malnutrition of muscles and tendons;dysfunction of spleen in transportation,dampness-heat pouring down;failure of spleen to rise the clear and deficiency of yang qi.Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤),Xuefu Zhuyu Decoction(血府逐瘀汤),Shaoyao Gancao Decoction(芍药甘草汤)and Guipi Decoction(归脾汤)and other prescriptions are modified for treatment.