不同中医证候糖尿病脑病的中药防治研究进展

Progression of research on traditional Chinese medicine in prevention and treatment diabetic encephalopathy with different symptoms

关键词:  糖尿病脑病  中药  认知障碍  不同证候

Key words:  diabetic encephalopathy  traditional Chinese medicine  cognitive impairment  different syndromes

摘要:

随着人们生活方式及饮食结构的变化，代谢性疾病逐年高发，并且其中枢神经系统发症，如糖尿病脑病日益受到人们的关注。糖尿病脑病的发病机制复杂且尚不明确，目前西医尚无有效治疗药物并且临床缺乏个性化治疗方案。中医学认为糖尿病患者阴阳两虚，久病入络，气机逆乱，肾精亏虚，故而浊毒内生，损伤脑络，发为脑病。参考文献及临床研究，总结归纳糖尿病脑病患者表现的常见证候类型：肾虚髓减证，脾肾两虚证，痰浊瘀阻证，肾虚瘀阻证，气阴两虚、瘀阻证。基于传统中医药理论的辨证论治可有效改善糖尿病患者的认知损伤及证候表现，实现临床个性化诊疗和精准用药，显著体现中药临床价值及优势。文章主要对目前临床辨证论治糖尿病脑病的中药复方及其机制进行了系统整理，以期为临床精准防治糖尿病脑病提供参考依据。

Abstract:

With the changes of people’s lifestyle and diet structure，the incidence of metabolic diseases is increasing year by year，and the central nervous system diseases，such as diabetic encephalopathy（DE），are attracting increasing attention. The pathogenesis of DE is complex and unclear. At present，western medicine has no effective treatment drugs and there is a lack of personalized clinical treatment plan. Traditional Chinese medicine believes that diabetes patients with yin and yang deficiency，chronic disease into collaterals，qi machinery counter disorder，kidney essence deficiency，so the turbid toxin is endogenous，damaging the brain collaterals and causing brain disease. With reference to literature and clinical research，the common syndromes of DE patients were summarized as follows：kidney deficiency and pulp reduction syndrome，spleen and kidney deficiency syndrome，phlegm turbidity-stasis syndrome，kidney deficiency and stasis syndrome，qi and yin deficiency and stasis syndrome. Syndrome differentiation and treatment based on traditional Chinese medicine theory can effectively improve the cognitive impairment and syndrome manifestations of diabetes patients，realize clinical personalized diagnosis and treatment and precise medicine，and reflect the clinical value and advantages of traditional Chinese medicine. In this paper，traditional Chinese medicine compound and their mechanisms for the clinical treatment of DE based on syndrome differentiation were systematically summarized，in order to provide reference for the precise prevention and treatment of DE in clinical practice.