| 引用本文: |
何萍, 王斌, 王彬.以“气脉常通”立论探讨痛性糖尿病周围神经病变[J].湖南中医药大学学报,2026,46(4):765-771[点击复制] |
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| 以“气脉常通”立论探讨痛性糖尿病周围神经病变 |
| 何萍,王斌,王彬 |
| (天津中医药大学第一附属医院, 天津 300381;中医国家临床医学研究中心, 天津 300381) |
| 摘要: |
| 痛性糖尿病周围神经病变（PDPN）是糖尿病常见的难治性并发症，现代医学在镇痛治疗方面效果欠佳。本文基于“气脉常通”理论，系统阐述PDPN的病机与治则，认为“气脉不通”是贯穿PDPN全程的核心病机，以脾肾亏虚、气脉虚滞为始动因素；以阳虚寒凝、气脉凝滞为重要环节；以痰瘀互结、气脉痹阻为传变与转归趋势。据此确立“扶正祛邪、标本兼治”的治则，以益气养阴治其本、温化寒凝调其枢、化痰祛瘀治其标。并附验案一则，以资佐证，为临床辨治提供新思路。 |
| 关键词: 痛性糖尿病周围神经病变|气脉常通|气脉不通|脾肾亏虚|阳虚寒凝|痰瘀互结|扶正祛邪|标本兼治 |
| DOI：10.3969/j.issn.1674-070X.2026.04.015 |
| 投稿时间：2025-11-29 |
| 基金项目:河北省中医药管理局科研计划项目（2025146）；国家卫生健康委能力建设和继续教育中心（国家卫生健康委党校）2025年度慢病管理研究课题（GWJJMB202510024008）。 |
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| Treatment of painful diabetic peripheral neuropathy from the perspective of "qi sufficiency and vessel patency" |
| HE Ping, WANG Bin, WANG Bin |
| (First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China;National Clinical Research Center for Chinese Medicine, Tianjin 300381, China) |
| Abstract: |
| Painful diabetic peripheral neuropathy (PDPN) is a common and refractory complication of diabetes mellitus, with limited efficacy of modern analgesic treatments. Based on the theory of "qi sufficiency and vessel patency", this article systematically elaborates on the pathogenesis and treatment principles of PDPN. It proposes that "qi deficiency and vessel obstruction" is the core pathogenesis throughout the entire course of PDPN. Spleen-kidney deficiency with qi deficiency and vessel obstruction serves as the initiating factor; yang deficiency with cold congelation leading to qi deficiency and vessel obstruction constitutes a key link; and intertwined phlegm and blood stasis resulting in qi deficiency and vessel obstruction represents the trend of disease progression and transformation. Accordingly, the treatment principle of "reinforcing healthy qi to eliminate pathogenic factors while addressing both root and manifestation" is established: supplementing qi and nourishing yin to treat the root, warming and resolving cold congelation to regulate the pivot, and transforming phlegm and eliminating stasis to treat the manifestation. A representative case is provided as evidence, offering new insights for clinical differentiation and treatment. |
| Key words: painful diabetic peripheral neuropathy|qi sufficiency and vessel patency|qi deficiency and vessel obstruction|spleen-kidney deficiency|yang deficiency with cold congelation|intertwined phlegm and blood stasis|reinforcing healthy qi to eliminate pathogenic factors|treating both root and manifestation |
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