李小娟教授治疗糖尿病性下肢动脉硬化闭塞症的经验总结

发布时间：2018-03-25 00:28

本文选题：糖尿病性下肢动脉硬化闭塞症　切入点：辨证论治　出处：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:总结李小娟教授治疗糖尿病性下肢动脉硬化闭塞症(diabetes lower extremity arteriosclerosis obliterans DLASO)的学术思想、临床经验、选方用药特色,为临床治疗DLASO提供行之有效方法和思路。材料与方法:通过跟师临床学习,记录临床资料,积累典型病例,对所得资料进行整理、分析、总结,归纳出李师治疗DLASO的辨证论治思路及治疗特色。结果:1.李小娟教授对DLASO病因病机的认识:发生于消渴病后期,由于脏腑功能失调,气血阴阳亏损,痰瘀热毒内生,导致络脉病变,渐至络脉闭阻,皮肤、肌肉、筋骨失于濡养,最终发为本病。2.李小娟教授对DLASO的辨证施治:(1)根据络病学说,总结出以化痰瘀、调气血为本病治疗原则,指导遣方用药;(2)合并感染后应重视清热解毒药的应用,相当于西医的抗炎治疗;(3)根据临床表现,将本病分为阳气亏虚,络脉寒凝、气阴两虚,络脉瘀阻、脾阳不足,痰湿瘀结、阴虚邪恋,热毒瘀结、气血不足,络脉失养5种证型,辨证而治之。3.李小娟教授对于DLASO的治疗特色:(1)疼痛:概括为不通则痛和不荣则痛,以“通”为治疗大法,以活络效灵丹为基础方,常加虫类药和藤类药;(2)麻木:分为虚证和实证,以“调营卫、和气血”为治疗原则,以黄芪桂枝五物为主方加减应用;(3)手足厥逆:以阳气不通和不足为主,重在温阳通脉,故以当归四逆汤为主,根据不通和不足之偏重,调整主方方向。结论:李师应用络病理论论治DLASO,临床疗效显著,具有研究和学习价值。
[Abstract]:Objective: to summarize Professor Li Xiaojuan's academic thought, clinical experience, and characteristics of prescriptions and medication of lower extremity arteriosclerosis obliterans DLASO in the treatment of diabetic lower extremity arteriosclerotic obliteration. Materials and methods: through clinical study, record clinical data, accumulate typical cases, collate, analyze and summarize the data. Results: 1. Professor Li Xiaojuan's understanding of the etiology and pathogenesis of DLASO: it occurred in the late stage of thirst disease, due to the dysfunction of viscera function, deficiency of qi, blood, yin and yang, phlegm, blood stasis, heat and toxin endogenously. Leading to collateral disease, gradually reaching to collaterals blocking, skin, muscles, muscles lost in moisturizing, and eventually causing this disease .2. Professor Li Xiaojuan's syndrome differentiation and treatment of DLASO: 1) according to collateral disease theory, summed up the treatment principle of resolving phlegm and blood stasis and regulating qi and blood. After infection, we should attach importance to the application of heat-clearing and detoxifying drugs, which is equivalent to the anti-inflammatory treatment of western medicine. According to the clinical manifestations, the disease is divided into deficiency of yang qi, cold coagulation of collaterals, deficiency of both qi and yin, stagnation of collaterals, deficiency of spleen yang, phlegm dampness and stasis. Yin deficiency evil love, heat toxin and blood stasis knot, deficiency of qi and blood, deficiency of collaterals and blood, differentiation and treatment of five syndromes. 3. Professor Li Xiaojuan's treatment feature for DLASO: pain: in general, it is painful if it is not clear, and when it is not glorious, it is treated with "Tong". Based on the prescription of Huoluoxiongling Dan, often added insect and rattan drugs to numb: divided into deficiency syndrome and empirical, with "regulating the operation of Wei, and Qi and blood" as the treatment principle, With Huangqi Guizhi Wuwu prescription plus or minus application of Gui 3) hand and foot syncope converse: Yang-qi impassable and insufficient mainly, the emphasis is on warming Yang and Tongmai, so Danggui Sini decoction is the main one, according to the impassable and insufficient emphasis, Conclusion: applying the theory of collateral disease to treat DLASO has remarkable clinical effect and has the value of research and study.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R249

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