周国英教授运用补阳还五汤治疗消渴痹证经验

胡光华

【摘要】总结周国英教授运用补阳还五汤治疗糖尿病周围神经病变的经验。周国英教授认为，消渴日久，久病入络，瘀血阻络，脉络不通而致痹证，治疗可选用活血通络之药，但峻猛之品易伤脾胃，损伤根本，故老年人、体虚者不宜久用破血之品。临证治疗上多选用活血之品中药性平和者，如丹参、当归、川芎、赤芍、鸡血藤等通络之品，再佐以补脾益气之味，方拟补阳还五汤加减，临床疗效显著。

【关键词】糖尿病周围神经病变;周国英;补阳还五汤;消渴痹证;气虚;血瘀

【中图分类号】R249.2/.7 【文献标志码】A【文章编号】1007-8517（2021）23-0088-04

Professor Zhou Guoying's Experience In Treating Arthralgia Syndrome of Eliminating Thirst with Buyang Huanwu Decoction

HU Guanghua

People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine， Fuzhou 350004，China

Abstract：To summarize Professor Zhou Guoying's experience in treating diabetic peripheral neuropathy （（DPN）） with Buyang Huanwu decoction. Old Zhou believes that the elimination of thirst for a long time， long-term illness into collaterals， blood stasis， blocked collaterals， resulting in arthralgia syndrome， can be treated with drugs for promoting blood circulation and dredging collaterals， but the fierce products are easy to hurt the spleen and stomach， and the damage is fundamental， so the elderly and the weak should not use blood-breaking products for a long time. In the clinical treatment， we often choose the moderate drugs in the products of promoting blood circulation， such as Salvia miltiorrhiza， Angelica sinensis， Ligusticum chuanxiong， Radix Paeoniae Rubra， Chicken Blood Rhizome and so on， and then add and subtract the taste of tonifying spleen and qi， and the clinical effect is remarkable.

Key words：Diabetic Peripheral Neuropathy;Zhou Guoying; Buyang Huanwu Decoction; Arthralgia Syndrome of Eliminating Thirst; Qi Deficiency; Blood Stasis

消渴痹證，即西医中的糖尿病周围神经病变（Diabetic peripheral neuropathy， DPN），是糖尿病微血管病变之一，其发病机制尚未完全明确^[1]，但超过50%的糖尿病患者最终会发展成DPN^[2]，是个发病率高、病程长的疾病。DPN的特点是周围神经由远端至近端变性，导致麻木、疼痛和深感觉减退等症状^[3]，给DPN患者的生活带来严重影响，然而目前西医治疗主要以控制血糖为主。中医在治疗DPN上有其优势，DPN属中医学“痹证”范畴，《证治准绳》云：“麻属痰属虚;木则全属湿痰死血。”周国英教授认为消渴痹证，乃气虚为本，病理因素以瘀血为主，血瘀为标，是本虚标实之病，治疗当以补气活血养血为宜，切不可破血逐瘀太过以免攻伐正气，方以补阳还五汤为代表。

周国英教授是全国第四批老中医药专家，对该病有着独到的见解，造诣颇深，笔者有幸跟随学习，受益匪浅，现将周国英教授运用补阳还五汤治疗消渴痹证的经验总结如下。……