从"燥热怫郁"理论探讨糖尿病下肢血管病变OA北大核心CSTPCD
Discussion on the diabetic lower extremity vascular disease from the theory of"dryness-heat and stagnation"
糖尿病下肢血管病变是糖尿病常见的慢性并发症之一,其致残率高,临床上,积极有效地控制疾病的进展,对提高患者生活质量具有重要意义.在《三消论》中,刘完素针对消渴病机提出了"燥热怫郁"理论,认为三焦胃肠燥热怫郁太甚,玄府闭塞,气液失宣,而发为消渴.血管内皮损伤、炎症反应是血管病变发生的重要因素,"燥热怫郁"的病机演变符合西医学炎症反应的病理特点,燥热贯穿于糖尿病下肢血管病变始终.本文认为,糖尿病下肢血管病变属中医学"痿痹"范畴,肺热叶焦为痿发生的根本原因,"燥热怫郁"为客热(燥热)之源,肺热叶焦,百脉失利,脉络瘀滞,发为糖尿病下肢血管病变.治疗上应从痿论治,结合刘完素《三消论》观点,以阳明为重,三消同调,解燥热怫郁之机,配伍泻南补北之法,使客热得清,肺热无源,则痿无所生,以期为临床防治糖尿病下肢血管病变提供新思路.
Diabetic lower extremity vascular disease is one of the common chronic complications of diabetes,which has a strong disabling effect,clinically,it is of great significance to actively and effectively control the progression of the disease and improve the quality of life of patients.In Sanxiao Lun,LIU Wansu put forward the theory of"dryness-heat and stagnation"according to the pathogenesis of consumptive thirst,and thought that the dryness-heat and stagnation in the stomach and intestines of sanjiao were too severe,the xuanfu was blocked,and the qi and liquid failed to diffuse,which caused diabetes.Vascular endothelial injury and inflammatory reaction are important factors in the development of vascular disease,the pathogenesis evolution of"dryness-heat and stagnation"conforms to the pathological characteristics of inflammatory reaction in western medicine,and the dryness-heat runs through the diabetic lower extremity vascular disease throughout.In this paper,it is believed that diabetic lower extremity vascular disease belongs to the category of"flaccidity and paralysis"in traditional Chinese medicine,and lung scorched by heat is the cause of flaccidity."Dryness-heat and stagnation"is the source of invading heat(dryness-heat),lung scorched by heat,pulse failure and vein stasis occurred,which causes diabetic lower extremity vascular disease.Treatment should be based on flaccidity,combined with the viewpoint of LIU Wansu's Sanxiao Lun,taking yangming as the top priority,regulating the triple diabetes,solving the problem of dryness-heat and stagnation,combined with the method of purging the south and supplementing the north,so that the invading heat is cleared,lung heat is diminished,and flaccidity disease cannot occur,in order to provide new ideas for the clinical prevention and treatment of diabetic lower extremity vascular disease.
杨若荻;刘军彤;李嘉鑫;周莹;焦子彧;杨宇峰;石岩
辽宁中医药大学 沈阳 110847
中医学
燥热怫郁肺热叶焦糖尿病下肢血管病变痿痹
dryness-heat and stagnationlung scorched by heatdiabetic lower extremity vascular diseaseflaccidity and paralysis
《北京中医药大学学报》 2024 (004)
472-477 / 6
国家中医药管理局青年岐黄学者项目(国中医药人教函[2022]256 号);辽宁省中央引导地方科技发展专项(No.2019JH6/10200009);2023 年辽宁省教育厅高校基本科研项目(No.JYTZD2023197) Young Qihuang Scholar Project of National Traditional Chinese Medicine Administration(No.[2022]256)
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