李新华用中药封包法治疗糖尿病周围神经病变的临床经验

Clinical Experience of Li Xinhua in the Treatment of Diabetic Peripheral Neuropathy via Traditional Chinese Medicine Packet Therapy

摘要: 糖尿病周围神经病变(DPN)是糖尿病高发慢性并发症，临床发病率超50%，以感觉神经受累为典型特征，核心症状为肢体疼痛、麻木，部分患者还会出现感觉减退、肢端发凉等表现，严重时可引发糖尿病足、截肢等不良结局，严重影响患者身心健康与生活质量。目前DPN发病机制尚未完全明确，临床治疗以对症干预为主，西医常规治疗聚焦控糖、抑制氧化应激、改善微循环及止痛等，但疗效欠佳，且长期用药的副作用与患者药物耐受不佳等问题，限制了其临床应用。近年来，中医药凭借整体辨证、标本兼顾的诊疗优势，与DPN病程迁延、病机复杂的特点相契合，为治疗提供了新途径。重庆市名中医李新华从事相关临床工作30余年，对DPN中医病机有独特见解，尤其深耕“阳虚寒凝、络脉瘀阻”证型诊疗，自拟“温经通络散”以中药封包外治，疗效确切，相关经验如下。

Abstract: Diabetic peripheral neuropathy (DPN) is a highly prevalent chronic complication of diabetes with a clinical incidence of over 50%. It is characteristically featured by sensory nerve involvement, with core symptoms of limb pain and numbness. Some patients also present with hypoesthesia, acral coolness and other manifestations. In severe cases, it can lead to adverse outcomes such as diabetic foot and amputation, seriously impairing patients’ physical and mental health as well as their quality of life. At present, the pathogenesis of DPN has not been fully elucidated, and clinical treatment is mainly symptomatic intervention. Conventional Western medicine treatment focuses on glycemic control, inhibition of oxidative stress, improvement of microcirculation and analgesia, yet the curative effect is unsatisfactory. Moreover, problems such as side effects of long-term medication and poor drug tolerance in patients have limited its clinical application. In recent years, traditional Chinese medicine (TCM), boasting the diagnostic and therapeutic advantages of holistic syndrome differentiation and simultaneous treatment of the principal and secondary aspects of a disease, is highly compatible with the characteristics of DPN including protracted course and complex pathogenesis, thus providing a new approach for its treatment. Xinhua Li, a renowned TCM physician in Chongqing Municipality, has been engaged in relevant clinical work for more than 30 years and holds a unique insight into the TCM pathogenesis of DPN. He has particularly devoted himself to the diagnosis and treatment of the syndrome type of “Yang deficiency and cold congelation, blood stasis obstructing the collaterals”, and formulated the self-developed “Wenjing Tongluo Powder” for external treatment via Traditional Chinese Medicine Packet, achieving definite curative effects. The relevant clinical experience is summarized as follows.