基于“膜腠三焦”理论论治不宁腿综合征

Treatment of Restless Leg Syndrome Based on the Theory of “Sanjiao Composed by Membrane-Striae” Theory

摘要: 不宁腿综合征(RLS)是一种以静息状态下不可抗拒的肢体活动欲望为特征的感觉运动障碍性疾病，严重影响患者睡眠质量及日常生活。本文基于陈潮祖教授“膜腠三焦”理论，结合杨东东教授三十年临床经验，系统阐述RLS的中医病机与治疗体系。文章首先梳理“膜腠三焦”理论的核心内涵——三焦由膜原与腠理构成，为津气运行通道，归属肝系，心包为其神机之主；进而提出RLS的核心病机为“三焦失养，气津失调，神机被扰”。在此基础上，构建“通–荣–固”治疗体系：疏肝化浊以“通膜”，养阴柔筋以“荣膜”，滋补肝肾以“固膜”，标本兼顾，为RLS的临床诊疗提供了系统的理论依据，并对未来制定RLS的中医诊疗专家共识或临床路径提供理论支撑。

Abstract: Restless leg syndrome (RLS) is a sensorimotor disorder characterized by an irresistible desire for physical activity in the resting state, which seriously affects the quality of sleep and daily life of patients. Based on Professor Chen Chaozu’s theory of “sanjiao composed by membrane-striae”, combined with Professor Yang Dongdong’s 30 years of clinical experience, this paper systematically expounds the TCM pathogenesis and treatment system of RLS. Firstly, this paper combs the core connotation of the theory of “sanjiao composed by membrane-striae”. Sanjiao is composed of membrane origin and striae, which is the channel for the movement of body fluid, belonging to the liver system, and the pericardium is the main part of its spirit. Furthermore, it is proposed that the core pathogenesis of RLS is “sanjiao dystrophy, qi and fluid imbalance, and mental disturbance”. On this basis, a “tong-rong-gu” treatment system was constructed: soothing the liver and resolving turbidity to “unblock the membrane”, nourishing yin and softening tendons to “rong membrane”, nourishing liver and kidney to “solid membrane”, and taking into account the specimen, which provided a systematic theoretical basis and practical guidance for the clinical diagnosis and treatment of RLS.