张发荣治疗糖尿病皮肤瘙痒症经验

张发荣教授认为,糖尿病皮肤瘙痒症是整体病变的外在表现,脏腑病变及六淫邪气均可致痒,非独风也。其将糖尿病皮肤瘙痒症分为早期和中晚期,早期以热毒、湿热等实证为主,中晚期本虚标实、虚实夹杂,以肺脾气虚、血虚肝旺、气阴两虚证多见。治疗时强调以皮肤瘙痒症为纬,以消渴本病为经,从纵横两方面把握疾病病机;风邪和瘀血在糖尿病皮肤瘙痒症的发病中具有重要作用,疏风活血法当贯穿始终;同时内外合治,多法并用,强调预防,重视调神,屡获奇效。

ZHANG Farong's Experience in Treating Diabetic Cutaneous Pruritus

Professor ZHANG Farong holds that diabetic cutaneous pruritus is the external manifestation of the overall disease,and itches can be caused by not only wind pathogen but also the disease of zang-fu organs and the six pathogenic factors. He divides diabetic cutaneous pruritus into early and middle-late stage for syndrome differentiation and treatment. Excess syndromes such as heat-toxin syndrome and dampness-heat syndrome are always found in the early stage,while qi deficiency of both lung and spleen,blood deficiency and blazing liver fire,as well as deficiency of both qi and yin are more common in the middle-late stage. The characteristics of the pathogenesis of middle-late stage is deficient root and excessive branch,as well as intermingled deficiency and excess. During the treatment,it is emphasized that cutaneous pruritus is regarded as the latitude,and the original diabetes is regarded as the longitude. Both the two diseases and pathogenesis are supposed to be treated based on syndrome differentiation. The effect of wind pathogen and blood stasis in the pathogenesis of diabetic cutaneous pruritus are important,and the method of wind-dispersing and blood-activating runs through the whole treatment. At the same time,it is also necessary to combine a variety of internal and external treatment methods,emphasize prevention,and regulate the spirit,so as to achieve good effect.