摘要
糖尿病为当今临床常见的慢性代谢性疾病,足溃疡为其严重并发症之一,截肢率与死亡率日渐升高。现代医学虽可通过降糖、抗感染等手段改善症状,但常存在一定的局限性。中医学将糖尿病足基本病机概括为气血亏虚,脉络瘀阻。心为君主之官,可行血、生血、通脉,心主血脉功能失常在糖尿病足的发生过程中发挥重要作用,因此,可通过补益心气、滋阴养血、通阳复脉治疗糖尿病足。炙甘草汤以滋阴养血、通阳复脉为治则,通过补益心气以增强行血的动力,滋阴生血以纠正阴血的亏虚,温通心阳以改善脉道的舒缩功能,从整体上综合改善患肢的血流灌注。临床实践表明,针对不同证型,如兼有脾肾阳虚、痰瘀互结、湿毒内盛等,灵活辨证加减该方可显著改善患者症状。现代药理分析结果显示,炙甘草汤中多种活性成分具有降糖、促进血管新生及抗炎等功能,可促进糖尿病足溃疡的修复。炙甘草汤以“心-血-脉-足”整体调控为核心,结合辨证论治原则,为糖尿病足提供了多靶点干预策略,体现了中医学“标本兼治”“整体观念”的治疗特色,其机制与疗效的深入探索可为中西医结合诊疗糖尿病足提供更多的实践与科学依据。
Diabetes is a common chronic metabolic disease in clinical practice nowadays.Foot ulcer is one of its serious complications,and the amputation rate and mortality rate are increasing day by day.Although modern medicine can improve symptoms through means such as lowering blood sugar and anti-infection,it often has certain limitations.In traditional Chinese medicine,the basic pathogenesis of diabetic foot is summarized as deficiency of qi and blood and obstruction of meridians.The heart is the sovereign organ,which can flow blood,generate blood and unblock meridians.When the heart governs the dysfunction of blood vessels,it plays a significant role in the occurrence of diabetic foot.Therefore,diabetic foot can be treated by tonifying heart qi,nourishing yin and enriching blood,and unblocking yang to restore meridians.Zhigancao Decoction adheres to the therapeutic principle of nourishing yin and enriching blood,promoting yang circulation and restoring the meridians.It enhances the power of blood circulation by tonifying heart qi,corrects the deficiency of yin and blood by nourishing yin and generating blood,and improves the contraction and relaxation function of the meridians by warming and promoting heart yang.It comprehensively improves the blood perfusion of the affected limb as a whole.Clinical practice shows that for different syndrome types,such as concurrent spleen and kidney yang deficiency,intermingling of phlegm and blood stasis,and excessive dampness and toxicity,flexibly adjusting the formula based on syndrome differentiation can significantly improve the patients'symptoms.Modern pharmacological analysis results show that various active components in the Zhigancao Decoction have functions such as lowering blood sugar,promoting angiogenesis and anti-inflammation,which can promote the repair of diabetic foot ulcers.Zhigancao Decoction,with the overall regulation of"heart-blood-pulse-foot"as its core,combined with the principle of syndrome differentiation and treatment,provides a multi-target intervention strategy for diabetic foot,reflecting the therapeutic characteristics of traditional Chinese medicine such as"address both symptoms and root causes"and"holistic concept".The in-depth exploration of its mechanism and therapeutic effect can provide more practical and scientific basis for the integrated diagnosis and treatment of diabetic foot with traditional Chinese and Western medicine.
作者
陈萌欣
宋莹莹
李想
CHEN Mengxin;SONG Yingying;LI Xiang(Integrated Chinese and Western Medicine School,Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing 210023,China;Chinese Medicine School,Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing 210023,China;The First Clinical School,Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing 210023,China)
出处
《中国当代医药》
2025年第19期95-99,共5页
China Modern Medicine
基金
江苏省中医药科技发展计划项目(MS2023003)
江苏省高等学校大学生创新创业训练计划项目(202310315112Y、202410315024Z)
江苏省南京市中西医结合疫病研究中心科研基金项目(NCMIC-2022-06)
关键词
糖尿病足
炙甘草汤
心主血脉
补益心气
滋阴养血
Diabetic foot
Zhigancao Decoction
Heart governing blood and vessels
Tonifying heart qi
Nourishing yin and generating blood
