基于“四位一体”理论探析黄芪桂枝五物汤治疗糖尿病性周围神经病机制

Exploring the Mechanism of Huangqi Guizhi Wuwu Decoction in the Treatment of Diabetic Peripheral Neuropathy Based on the “Four-in-One” Theory

摘要: 目的：探讨黄芪桂枝五物汤治疗糖尿病性周围神经病的机制。方法：运用“四位一体”理论，从“性、位、势、证”四个角度分析黄芪桂枝五物汤的作用机制。结果：方性甘温兼辛，具有温阳通痹、调和营卫、解表散寒的功效；方位为脾胃和肌表，健脾以补益气血，滋养肌肤；方势为由里向表，从脾胃向肌表，健运脾气所化生气血，随经络外达皮肉肌肤；方证为适用于气血亏虚，复感外邪之麻木、痹痛等症状。结论：黄芪桂枝五物汤通过健脾补气养血、温阳通络止痹的方法，治疗糖尿病性周围神经病气血亏虚、阳虚寒凝证型，同时可灵活运用活血、养阴、安神之法，扩展黄芪桂枝五物汤的适用范围。

Abstract: Purpose: To explore the mechanism of Jingfang treatment of diabetic peripheral neuropathy. Methods: Using the theory of “four in one”, the mechanism of action of Huangqi Guizhi Wuwu Decoction (黄芪桂枝五物汤) was analyzed from the four perspectives of “property, location, tendency and syndrome”. Results: First, the property of the formula is sweet and warm and pungent, which has the effect of warming yang qi and relieve pain, reconcile the battalion guards and relieving exterior syndrome; The location is the spleen, stomach and surface, which for strengthening the spleen to replenish qi and blood for nourishing the skin; The tendency is from the inside to the surface, from the spleen and stomach to the surface. Conclusion: The qi and blood incarnated by the healthy spleen and run in the meridians ended up reach the skin; The syndrome is deficiency of qi and blood with pathogen, it applies to the numbness and pain. The analysis of the therapeutic mechanism of Jingfang in the treatment of diabetic peripheral neuropathy through the “four-in- one” theory is of great significance to the research and clinical application of Jingfang.