从脾论治糖尿病下肢大血管病变

从脾论治消渴及消渴之并发症血痹脱疽,首先在标本论治思想的指导下,从脾之生理功能出发,以运化生化之功能论治其气阴本虚,以提升统摄之功能论治其瘀血标实;其次,从脾之生理特性出发,"脾主四肢,在体合肉",肢体末端、关于肉的病变,自当责之于脾;接着在"脏-腑-经-皮"的内外观念下,可以看到下肢大血管的病变部位与足太阴经和足阳明经有一定的联系;最后在整体论的观念下,探讨脾与肺、肾、胰的关系,认为"消虽分三部,皆与脾关"。总之,"脾虚致消"为糖尿病之根,而"脾虚致瘀"为糖尿病下肢大血管病变之根。从脾论治糖尿病及下肢大血管病变有一定的临床意义。

Treating Lower Extremity Macrovascular Disease from the Spleen

In terms of treating diabetes and its complication:blood arthralgia gangrene,first,under the guidance of treating principal or secondary aspect of disease,starting from the physiological function of spleen,according to the spleen's transporting and biochemical function,treat the patient's qi and yin deficiency to enhance the function of the spleen and treat blood stasis and excessive principal aspect.Second,starting from the spleen's physiological characteristics that " the spleen is in charge of the limbs,and coordinates with the muscles",the spleen should be responsible for the pathological changes of the end of limbs and muscles.Third,according to the interior-exterior concept of "zang-fu-channel-skin",it is easy to find that lower extremity macrovascular disease has something to do with foot taiyin and foot yingming meridians.Finally,according to the concept of wholism,explore the relationship between the spleen and the lung and the kidney and the pancreas,because "diabetes has three parts,but each has something to do with the spleen." In a word,"spleen deficiency leading to consumptive and thirst disease" is the root of diabetes,while "spleen deficiency leading to blood stasis" is the root of lower extremity macrovascular disease.So treating diabetes and lower extremity macrovascular disease has certain clinical significance and is worth studying.