基于肝脾肾同调理论辨治痛性糖尿病周围神经病变思路

Ideas of differentiating and treating painful diabetic peripheral neuropathy by regulating the liver,spleen and kidney

痛性糖尿病周围神经病变(PDPN)是一种常见的糖尿病并发症。高思华教授认为其虽以疼痛为主要表现,仍以糖尿病为发病源流,蕴含着肝脾肾三脏同病,正虚邪实互见而出现的脉络失养、受损、痹阻等一系列过程。临证时应在中医整体观的指导下,动态看待脏腑间的相互联系和糖尿病及其并发症的关系,根据患者症状、舌、苔、脉的变化,及时调整用药思路,止痛的同时控制PDPN产生的根源,在平调肝脾肾三脏的基础上,视正虚邪实的性质有针对性地治疗疼痛,标本同治。

Painful diabetic peripheral neuropathy is a common diabetic complication.Professor GAO Sihua proposes that although pain is the main manifestation,diabetes is still the source of the disease,which contains a series of processes such as the loss of nutrition,damage,and blockage of the venation due to the same disease of the liver,spleen and kidney,and the interaction between positive deficiency and evil.Under the guidance of the holistic view of traditional Chinese medicine,we should dynamically look at the relationship between the changes of the Zang-Fu organs and diabetes mellitus and its complications.Timely adjust the medication ideas according to the changes of the patient's symptoms,tongue,fur,pulse phase,and control the root causes of PDPN while relieving pain.On the basis of regulating the liver,spleen and kidney,we should treat pain according to the nature of the deficiency of the vital energy and the excess of the pathogenic energy,and treat the symptoms and root causes simultaneously.