基于“痰–瘀–虚”理论探讨神经病理性疼痛的发病机制及中医治疗

Discussion on the Pathogenesis and Chinese Medicine Treatment of Neuropathic Pain Based on theTheory of “Phlegm-Stasis-Deficiency”

摘要: 神经病理性疼痛(NP)是一种由躯体感觉神经系统的病变或疾病引起的疼痛，在祖国医学中归类为“痛证”、“痹证”等范畴。尽管研究显示一些止痛类中药对改善神经病理性疼痛具有显著疗效，但在中医基础理论方面对其整体病机演变规律尚未得到广泛研究和共识。基于神经病理性疼痛的发病机制和临床特点，从“痰–瘀–虚”的角度探讨了神经病理性疼痛的发展演变过程，系统阐释了“痰–瘀–虚”的理论内涵以及与神经病理性疼痛之间的关系，深入了解其发病机制，并提出“祛痰通络，活血化瘀，补虚扶正”的中医药防治策略，为预防和治疗神经病理性疼痛提供了新的方向和思路。

Abstract: Neuropathic pain (NP) is a type of pain caused by lesions or diseases of the somatosensory nervous system, classified in traditional Chinese medicine as “pain syndrome” and “bi syndrome.” Although studies have shown significant therapeutic effects of certain analgesic traditional Chinese medicines in alleviating neuropathic pain, there is still limited research and consensus on the overall pathogenesis from the perspective of traditional Chinese medicine theory. Therefore, based on the pathogenesis and clinical characteristics of neuropathic pain, explores the developmental process of neuropathic pain from the perspective of the “phlegm-stasis-deficiency” theory. It systematically elucidates the theoretical implications of “phlegm-stasis-deficiency” and its relationship with neuropathic pain, providing a deeper understanding of its pathogenic mechanisms. The paper proposes a traditional Chinese medicine prevention and treatment strategy of “dispelling phlegm, promoting blood circulation, resolving stasis, nourishing deficiency, and strengthening the body,” offering new directions and insights for the prevention and treatment of neuropathic pain.