Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

Effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors

Objective:To investigate the effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors.Methods:132 patients with early diabetic retinopathy from June 2017 to July 2019 in our hospital were randomly divided into the control group(66 cases)and the observation group(66 cases);The control group was treated with epalrestat,and the observation group was treated with epalrestat combined with ginkgo damo injection;The treatment effect,blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of the two groups were compared.Results:The treatment efficiency of the observation group(96.96%)was significantly higher than that of the control group(84.84%)(P<0.05).After 3 months of treatment,the high-cut whole blood viscosity(3.62±0.45 mPa/s),low-cut whole blood viscosity(1.54±0.26 mPa/s),erythrocyte sedimentation rate(15.63±2.97 mm/s)of the observation group compared with the control group(4.57±0.52 mPa/s,2.91±0.30 mPa/s,22.36±3.38 mm/s)were significantly lower(P<0.05).After 3 months of treatment,the SOD(93.41±10.17 nmol/mL)and TAC(20.57±3.76 u/mL)of the observation group compared with the control group(82.26±9.45 nmol/mL,18.26±3.63 u/mL)were significantly higher(P<0.05),and the MDA of the observation group(9.22±1.98 u/mL)was significantly lower than that of the control group(12.13±1.06 u/mL)(P<0.05).After 3 months of treatment,the CRP(9.74±1.12 mg/L),IL-2(70.37±12.13 ng/L),TNF-a(11.36±2.08 ng/L)of the observation group compared with the control group(15.28±1.73 mg/L L,82.46±10.58 ng/L,16.28±2.43 ng/L)were significantly lower(P<0.05).Conclusion:Epalrestat combined with Huoxue Huayu preparation is more effective in the treatment of early diabetic retinopathy,and can significantly improve the blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of patients.

Novel technologies and models for studying pharmacological activities of traditional Chinese medicine for promoting blood circulation and removing blood stasis

OBJECTIVE Our previous studies demonstrated that various ingredients from the traditional Chinese medicine(TCM)for promoting blood circulation and removing blood stasis,as exemplified by cryptotanshinone and salvianolic acid B,exerted striking effects on modulating angiogenesis and vascular permeability,which suggests that they may be effective in treating vascular leak-driven diseases(e.g.tumor,cerebral cavernous malformation and diabetic retinopathy).However,the lack of reliable and advanced technologies and models sets up difficult hurdles for better understanding the role of TCM for promoting blood circulation and removing blood stasis.To this end,this study is to outline numerous cutting-edge platforms that can be utilized for exploring the function of TCM for promoting blood circulation and removing blood stasis in vascular leak-driven diseases.METHODS Two-photon laser scanning fluorescence microscopy was used to observe the interactions between neutrophils and blood vessels in a real-time manner.Dynamic flow system was employed to mimic the in vivo behaviors of neutrophils.RIP1-Tag5 spontaneous pancreatic cancer model was used to study the function of tumor blood vessels.CCM2ECKO(deletion of CCM2 in endothelial cells)mice were employed to establish the cerebral cavernous malformation(CCM)animal model.Micro-computed tomography(micro-CT)was utilized to assess the CCM lesion.Müller cell-knockout mouse model was used to study the progression of diabetic retinopathy.Vascular permeability in this model was assessed by fluorescein angiography.RESULTS The interactions between neutrophils and endothelial cells involve a series of complicated processes,including rolling,adhesion,intraluminal crawling and transmigration,which were all monitored in vivo by two-photon laser scanning fluorescence microscopy in a real-time manner.Dynamic flow system was capable of recapitulating the biological behaviors of neutrophils in vitro.Tumor vascular function in particular vascular perfusion could be assessed in the RIP1-Tag5 spontaneous pancreatic cancer model.In terms of CCM studies,specific deletion of CCM2 in endothelial cells resulted in the initiation of CCM lesion.The size and number of CCM lesions could be visualized and quantified by micro-CT.Furthermore,the Müller cell-knockout mouse model was able to precisely reflect the clinical symptoms of diabetic retinopathy.Vascular leak could be monitored at different time points using fluorescein angiography.CONCLUSION An array of high technologies and animal models can be used in investigating the occurrence and progression of multiple vascular leak-driven diseases.The pre-clinical and clinical studies of TCM for promoting blood circulation and removing blood stasis provide fundamental support for the application of the above-mentioned platforms,with the purpose of uncovering the scientific basis of TCM for promoting blood circulation and removing blood stasis.

益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清Vaspin和SCUBE2水平的影响

目的:观察益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)和骨形态发生蛋白1-表皮生长样结构域蛋白2(SCUBE2)水平的影响。方法:选择2021年1月至2022年12月于该院治疗的糖尿病视网膜病变患者102例,以随机数字表法分组。对照组50例患者给予常规西医治疗,观察组52例患者在对照组的基础上给予益气养阴化瘀方治疗。比较两组患者的临床疗效、治疗前后的中医证候评分,检测视野平均敏感度、视力、收缩期血流速度峰值、眼动脉阻力指数(RI)和舒张期血流速度峰值,检测患者Vaspin、低氧诱导因子-1(HIF-1)、可溶性细胞黏附分子(sICAM-1)、SCUBE2、外周血内皮细胞(CEC)和循环祖细胞(CPC)水平。结果:观察组患者总有效率为98.08%(51/52),高于对照组的84.00%(42/50),差异有统计学意义(P<0.05)。治疗后,观察组患者的中医证候评分较对照组降低,差异有统计学意义(P<0.05)。治疗后,观察组患者的RI低于对照组,收缩期血流速度峰值、舒张期血流速度峰值、视野平均敏感度和最佳矫正视力高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者的CPC水平较对照组升高,CEC水平较对照组降低,Vaspin、HIF-1、sICAM-1和SCUBE2水平较对照组降低,差异均有统计学意义(P<0.05)。结论:益气养阴化瘀法治疗糖尿病视网膜病变,可改善患者微血管功能、动脉血流、微视野和视力,提高临床疗效。

“肝脾同调-血水同治”对增殖性糖尿病性视网膜病变PPV围手术期的影响

目的探究“肝脾同调-血水同治”对增殖性糖尿病性视网膜病变(proliferative diabetic retinopathy,PDR)玻璃体切除术(pars plana vitrectomy,PPV)患者围手术期的影响。方法选取2021年6月—2023年6月本院收治的63例PDR患者,按照简单随机法分为常规组(n=31)和同调组(n=32),常规组给予常规围术期治疗(术前3~5 d至术后7 d),同调组在常规组基础上实施“肝脾同调-血水同治”治法,比较2组临床指标、并发症(高眼压、玻璃体积血、视力下降)、眼压、炎症反应分级(前房闪辉、前房炎症细胞、纤维蛋白渗出),干预前后炎症因子水平[前房液白细胞介素-6(Interleukin-6,IL-6)、血清C反应蛋白(C-reactive protein,CRP)]。结果同调组手术时间、住院时间低于常规组(P<0.05);2组并发症总发生率比较无统计学意义(P>0.05);术后1 d、3 d,2组眼压均随时间延长而下降(P<0.05),且术后1 d同调组低于常规组(P<0.05);术后1 d、1周,2组前房闪辉、前房炎症细胞和纤维蛋白渗出评级随时间延长明显减轻(P<0.05),且术后1 d同调组前房闪辉评级明显低于常规组(P<0.05);术后1 d、1周,2组前房液IL-6、血清CRP均随时间延长而降低(P<0.05),且同调组均低于常规组(P<0.05)。结论“肝脾同调-血水同治”应用于PPV治疗的PDR患者,可减少患者围术期并发症,有效控制炎症反应,缩短手术时间和住院时长,具有临床应用价值。

活血化瘀类中成药治疗糖尿病视网膜病变的网状Meta分析

目的:应用网状Meta分析方法,比较不同活血化瘀类中成药治疗糖尿病视网膜病变(DR)的临床有效率、实验室指标改善情况及治疗的安全性。方法:通过检索中国知网(CNKI)、万方数据知识服务平台、维普期刊资源整合服务平台(VIP)、Web of Science及Pubmed等数据库获得关于活血化瘀类中成药治疗DR的临床随机对照研究,检索时限为建库至2023年4月10日,并对所检索到的文献进行筛选提取资料,通过Stata 16.0软件实施网状Meta分析。结果:最终纳入63项研究,分析结果显示:复方丹参滴丸+羟苯磺酸钙胶囊总体疗效最为显著;芪明颗粒+羟苯磺酸钙胶囊在改善DR患者视力方面疗效最为显著;复方血栓通胶囊+羟苯磺酸钙胶囊在改善DR患者黄斑厚度及视野灰度值方面疗效最好;和血明目片+羟苯磺酸钙胶囊在减小患者血管瘤体积方面疗效较好;治疗组与对照组均有不良反应报道,治疗组不良反应总体较少。结论:与单用羟苯磺酸钙胶囊比较,活血化瘀类中成药联合羟苯磺酸钙胶囊治疗DR患者,可提高临床有效率,改善患者实验室检查指标,减少不良反应。

Correlativity between blood measures related to blood stasis blocking collaterals and gene expression of angiotensin-converting enzyme of renal cortex in diabetic rats and effect of stasis removing and collaterals dredging

OBJECTIVE: To investigate the correlativity between the changes of blood measures related to blood stasis blocking collaterals and gene expression levels of angiotensin-converting enzyme(ACE)and ACE2 ofrenal cortex in diabetic rats with stasis blocking collaterals syndrome, as well as the effectof stasis removing and collaterals dredging.METHODS: Male Sprague-Dawley rats were divided randomly into normal control group(C group),high-carbohydrate-fat control group(H group) and streptozotocin(STZ)-injecting group. The diabeticrats were induced from rats in the STZ-injecting groupby high-carbohydrate-fat diet combined with STZ intraperitoneal injection, with sustained high-carbohydrate-fat diet fed afterwards, and were further divided into model group(M group)and Chinese medicine of stasis removing and collaterals dredging group(Z group). Rats in the Z group were fed with stasis-removing-and-collaterals-dredging herbal granule suspension intragastrically daily for 16 weeks, while drinking water of corresponding volume was administrated to the rats in other groups. At the end of the 16 th week after successful establishment of models, the ultrastructures of glomeruli in different groups were detected by a transmission electron microscopy; and blood measures related to blood stasis blocking collaterals, including lipid profile and blood viscosity measures, were tested, as well as the relative gene expressions of ACE and ACE2.RESULTS: Changes in ultrastructures of glomeruli in the M group were characterized by lack of clarity in structure and occasional thickening of glomerular basement membrane and extensive fusion in foot processes. The correlation analysis showed that there were positive correlations between lipid profile, blood viscosity, and the ACE mRNA expression levels in the M group(P<0.05), except for cholesterol. And except for triglyceride, the blood measures were in negative correlation with the ACE2 mRNA expression levels in the M group(P<0.05).Compared with the C and H groups, the lipid profile, plasma viscosity and blood viscosity were significantly higher(P<0.01). All the above-mentioned measures were significantly improved in the Z group rats(P<0.05). ACE mRNA expression was significantly higher in the M group thanin the C group(P<0.05). ACE2 mRNA level was significantly lower in the M group than in the C and H groups(P<0.01)and its levelin the Z group was higher than that in the M group(P<0.01).CONCLUSION: Blood measuresrelated to blood stasis blocking collaterals had positive linear correlations with ACE mRNAexpression and negative linear correlations with ACE2 mRNA expression in the M group. Chinese recipe of stasis removing and collaterals dredging could play a renal protecting role for diabetic rats by reducing lipid profile and blood viscosity, down-regulating ACE mRNA expression and up-regulating ACE2 mRNA expression.

益气养阴消牴通络中药对早期糖尿病大鼠肾组织Podocin基因表达的影响

目的探讨益气养阴、消牴通络中药对早期糖尿病大鼠肾组织Podocin基因表达的影响。方法将SD大鼠随机分为6组:肾切组、模型组、厄贝沙坦组、中药低、中、高剂量组,按各组相应药物剂量灌胃。于第6周末检测各组大鼠24 h尿蛋白(UPro)量及肾功能水平;RT-PCR检测肾皮质Podocin表达水平。结果厄贝沙坦、中药低、中剂量组与模型组比较UPro量显著下降(P<0.05);各治疗组与模型组比较,肾功能明显改善(P<0.05),且Podocin表达显著增加(P<0.01)。结论益气养阴、消牴通络中药可能通过减少Podocin蛋白的丢失,使肾小球滤过膜的完整性得到一定程度的恢复而减轻蛋白尿,从而发挥其对糖尿病肾病大鼠的治疗作用。

经方六君子汤加减对新发2型糖尿病伴脾气壅塞、痰瘀阻络型肥胖的干预作用

目的 探讨经方六君子汤加减对新发2型糖尿病伴脾气壅塞、痰瘀阻络型肥胖患者的临床效果。方法 选择2023年1月-2023年9月南京市六合区中医院收治的60例新发2型糖尿病合并肥胖患者随机分为观察组和对照组各30例。对照组予德谷门冬双胰岛素、盐酸二甲双胍治疗,观察组在对照组的基础上加用经方六君子汤加减治疗。比较两组治疗前后中医证候积分、腰围、体质量、身体质量指数(BMI)、空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)、血脂四项(甘油三酯[TG]、总胆固醇[TC]、低密度脂蛋白[LDL]、高密度脂蛋白[HDL])、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及不良反应。结果 治疗后,观察组总有效率明显高于对照组(P<0.05);两组中医证候积分、腰围、体质量、BMI、FBG、2 hPBG、HbA1c、TG、TC、LDL、HDL均明显改善(P<0.05),观察组均优于对照组(P<0.05)。治疗期间两组均出现低血糖1例,对照组腹泻1例,对症处理后好转,未出现明显血常规、肝肾功能异常。结论 新发2型糖尿病合并肥胖患者中加用经方六君子汤加减较单用德谷门冬双胰岛素联合盐酸二甲双胍片疗效更显著,可改善患者中医证侯积分、糖脂代谢相关指标等,不良反应少,效果满意。

基于目络理论探讨调血通络法在糖尿病视网膜病变治疗中的应用

糖尿病视网膜病变(diabetes retinopathy,DR)是最常见的糖尿病(diabetes mellitus,DM)慢性并发症之一,是工作年龄人群首位的致盲性眼病。其眼底表现为视网膜微血管瘤、出血、水肿、渗出、玻璃体积血,甚至视网膜脱离等,归属于中医眼科“消渴目病”“视瞻昏渺”“云雾移睛”等范畴。其眼底病变进行性加重,病因病机虚实夹杂,错综复杂。张铭连教授基于目络理论和多年的临床研究,认为其主要病理机制为“目络郁(瘀)阻”,调血通络法为其主要治法。本文将阐释基于目络理论制定的调血通络法在治疗DR的认识和临床应用。

补阳还五汤加减应用于气阴两虚兼血瘀型非增殖期糖尿病视网膜病变治疗对患者视功能的改善探讨

目的分析气阴两虚兼血瘀型非增殖期糖尿病视网膜病变患者行补阳还五汤加减治疗价值。方法选取2022年1月—2023年10月张家港市中医医院接收的气阴两虚兼血瘀型非增殖期糖尿病视网膜病变患者78例作为研究对象,采用随机数表法分为研究组和对照组,各39例。对照组西药治疗,研究组同时行补阳还五汤加减治疗,评定治疗后各项结果。结果研究组治疗有效率高于对照组,差异有统计学意义(P<0.05);研究组治疗后黄斑水肿、视网膜体积、黄斑中心凹视网膜厚度分别(0.68±0.24)分、(8.08±1.03)mm^(3)、(236.91±17.61)μm,均优于对照组,差异有统计学意义(t=4.034、3.015、3.361,P均<0.05);研究组治疗后视功能、血清生化值优于对照组,差异有统计学意义(P均<0.05)。结论补阳还五汤加减治疗气阴两虚兼血瘀型非增殖期糖尿病视网膜病变患者中,整体稳定度良好,有效率得到显著提升。

气阴两虚兼瘀阻经络证糖尿病高危足患者经复荣通脉胶囊辅助治疗的疗效及机制

目的研究气阴两虚兼瘀阻经络证糖尿病高危足患者经复荣通脉胶囊辅助治疗对其血液流变学及神经功能的影响。方法180例研究对象均选自河北省沧州中西医结合医院内分泌科2020年1月—2021年11月收治的糖尿病高危足患者,根据治疗方法的不同分为对照组(60例)以及观察组(120例)。两组均接受常规治疗,对照组在此基础上予以胰激肽原酶肠溶片,观察组在对照组基础上加用复荣通脉胶囊,两组均持续治疗24周。比较两组治疗后临床疗效,治疗前后踝肱指数(ankle brachial index,ABI)、足底峰值压力、中医症状评分,多伦多神经病变(Toronto clinical scoring system,TCSS)评分,血液流变学指标,神经传导速度以及治疗期间不良反应。结果治疗后,观察组临床总有效率高于对照组;与治疗前比,治疗后两组足底峰值压力、中医症状评分、TCSS各项评分及全血低切黏度、全血高切黏度、血浆黏度值、纤维蛋白原水平均降低,其中观察组低于对照组;ABI、腓总神经、胫神经、腓浅神经传导速度均升高,其中观察组高于对照组,差异有统计学意义(均P<0.05)。结论气阴两虚兼瘀阻经络证糖尿病高危足患者以复荣通脉胶囊辅助治疗能够有效降低足底峰值压力,改善血液流变学,提高神经传导速度,降低坏疽风险,疗效更佳。

李双蕾教授从肾虚络瘀探析糖尿病性骨质疏松症经验

糖尿病性骨质疏松症作为一种全身性骨代谢疾病,是糖尿病的重要并发症,也一直是临床的重难点。李双蕾教授是广西名中医,通过多年的临床实践与观察,在防治糖尿病性骨质疏松症方面经验丰富。消渴日久,虚实夹杂,肾虚骨络失养,肾主骨生髓功能降低则骨枯髓减发为“骨痿”;消渴日久,久病入络则瘀血瘀阻肾络,伏瘀伤骨,可进一步加速骨骼的损伤,形成恶性循环。李双蕾教授首先提出糖尿病性骨质疏松症的核心病机是肾虚血瘀、骨络受损,治疗当以补肾化瘀为主要原则。李双蕾教授根据壮骨方进行加减应用,对于糖尿病性骨质疏松症的临床诊治,取得了较好的实践效果。李双蕾教授着重从肾虚络瘀的致病特点出发,分析肾虚络瘀与糖尿病性骨质疏松症发病的关系,期望从不同的角度为临床论治糖尿病性骨质疏松症提供理论依据。

从“浊毒伏络”探讨糖尿病心肌病

糖尿病心肌病(DCM)属于中医学消渴并发心悸、胸痹范畴。结合现代浊毒理论、络病理论及糖尿病心肌病的病理特点,认为“浊毒伏络”是DCM起病之本,心络受损是DCM演变之机,气血阴阳俱虚是DCM的最终结局。根据“浊毒伏络”理论和疾病分期特点,治疗方面提倡早期化浊解毒、中期搜剔通络、后期补虚固本。

基于“瘀血阻络”证候特点探析糖尿病肾病血流动力学改变

糖尿病肾病是糖尿病最常见的微血管并发症,血流动力学的改变贯穿整个糖尿病肾病病变过程,长期高血糖引起的高灌注,严重影响肾小球滤过功能,患者肾脏血流受阻、肾功能降低、肾组织纤维化是疾病进一步恶化的主要原因。糖尿病肾病继发于糖尿病,中医认为其病程日久,在气阴两虚证的基础上,阴虚燥热血液凝炼加之气虚无力推动血液运行,瘀血阻滞肾络,这一变化与血流动力学改变不谋而合。因此文章将中医瘀血阻络理论与血流动力学改变相类比,以期从现代医学角度阐释“瘀血阻络”理论在糖尿病肾病发生发展过程中的作用,为糖尿病肾病临床诊疗提供思路。

基于肠道微生态探讨活血化瘀法治疗糖尿病性肾小球硬化

肾小球硬化是糖尿病肾病的主要病理特征之一,也是其进展的重要原因。肠道菌群及其代谢产物可通过血流动力学、炎症反应、氧化应激等多种途径影响肾小球硬化。中医学认为,肾络瘀阻是糖尿病性肾小球硬化的关键病机,活血化瘀法应贯穿治疗始终。研究发现,“瘀”与肠道菌群之间存在联系,应用活血化瘀药物可改善肠道微生态紊乱,达到延缓糖尿病性肾小球硬化的目的。本文以此为中心进行论述,探讨活血化瘀法改善肠道菌群及糖尿病性肾小球硬化的作用机制,为临床相关治疗提供参考。

刘德山从“血浊”论治糖尿病视网膜病变经验

刘德山教授在“血浊”理论基础上,结合糖尿病视网膜病变的病证特点,开创性提出糖尿病视网膜病变“阴虚始动,瘀痹终局,血浊贯通枢垣”的病机演化特点,归纳总结出滋阴、清浊、化瘀、滋肝肾四法。具体用药上,滋阴分缓急,急时救阴,以石膏、知母类为重,缓时育阴,以生地黄、麦冬、石斛为主;清化血浊多用桑叶、葛根;化瘀药分期用之,非增殖期病变选丹参、川芎、水蛭、地龙等配伍,增殖期病变时以三七、蒲黄、仙鹤草为主;滋肝肾多选药性平和者,并喜加少量山茱萸以求阴阳共济。

基于“玄府-络脉”理论探讨糖尿病视网膜病变血-视网膜屏障损伤

目前,针对恢复血-视网膜屏障(Blood-retina Barrier,BRB)损伤的治疗手段十分有限,而中医从BRB角度认识并以此指导治疗糖尿病视网膜病变(Diabetic Retinopathy,DR)也很少述及。BRB位于血液与视网膜神经组织间,是物质交换、信息交流的场所。BRB受损是DR的关键病理机制,是导致患者失明的关键原因。玄府与络脉是人体结构中最普遍的微观结构,承担着流通气血津液、津血互渗及运转神机的功能。文章针对BRB与玄府-络脉的形态、结构、功能进行相关性分析,并基于“玄府-络脉”理论提出玄府闭塞、玄府破损与目络瘀阻失荣是BRB受损的重要病机,从而确定“和玄”、通络、补虚的基本治疗原则。文章还总结了虫类药、辛味药等在治疗BRB损伤中的特色治疗作用。

益气活血法在糖尿病视网膜病变中的应用

糖尿病视网膜病变是糖尿病常见的微血管并发症之一,以视网膜毛血管闭塞为特征,多出现视网膜微血管瘤、水肿、出血等,导致患者视物不清甚至失明。目前西医的治疗手段时效性差,存在一定的不良反应。中医在治疗上更注重整体观,调畅全身气血,改善患者视力,《黄帝内经》中认为水与血均由水谷精微化生,气血亏虚不以奉养全身则精气无法上注于目导致多种目病。本文基于糖尿病视网膜病变的中医病因病机结合现有实验及临床研究结果阐述益气活血法治疗糖尿病视网膜病变的机制。

虫类药外治法在糖尿病足溃疡治疗中的应用:基于“久病入络”理论

中医认为,糖尿病足溃疡的病机多为脾肾亏虚、气滞瘀阻,与“久病入络”的病因病机、临床症状类似。现代研究表明,虫类药物具有抗炎、抗菌、抗凝血、溶栓等作用,可直接或间接促进溃疡创面愈合。“久病入络”理论对于临床上运用虫类药物治疗糖尿病足溃疡具有指导意义。