摘要
神经病理性疼痛作为一个涵盖了多种疾病的临床概念,患病率高,具有复杂的发病机制。现代医学虽有针对不同机制的治疗药物,但效果有限且存在较为显著的不良反应。清代温病学家叶天士对前人治痛之法进行继承和发扬,衍生出了“久痛入络”理论。鉴于神经病理性疼痛病程、发病机制及临床表现的特殊性,尤其适用于此理论进行诊治。该研究认为在神经病理性疼痛中,久痛所入之络实为层次较深的“阴络”,即髓络,病性当属本虚标实,以脏腑功能失调为前提、络脉空虚为基础,与肝、肾、心之功能失调密切相关。该病病机可归纳为神经系统疾病或损伤迁延不愈,耗损气血,髓中络脉空虚,气血运行不畅,导致瘀血、痰湿等有形病理产物形成而凝滞于络内,不通则通,迁延难愈。该病的治则以通法贯穿于始终,具体包括辛味通络、虫类通络、藤类通络和络虚通补等。该文基于“久痛入络”理论阐述了神经病理性疼痛的中医发病机制及相关治法,为从中医络病学角度认识与防治该病提供了新思路。
Neuropathic pain is a clinical symptom with complex mechanisms and high incidence.The commonly used analgesics have limited efficacy and can cause serious side effects.The theory of chronic pain entering collaterals was proposed by YE Tianshi,a famous physician focusing on warm diseases in the Qing dynasty,on the basis of the ancient therapies for pain.This theory is particularly suitable for the diagnosis and treatment of neuropathic pain in view of the clinical course and manifestations.The chronic neuropathic pain can enter the Yin collateral in deeper sites.The pathogenesis of neuropathic pain is summarized as a deficiency in origin and excess in superficiality.The root cause is the dysfunction of Zang-Fu organs,mainly the liver,kidney and heart,while the superficial causes are phlegm and stasis caused by the obstructed Qi and blood movement due to the consumption of Qi and blood in collaterals.Accordingly,the therapies such as dispelling blood stasis,resolving phlegm,and dredging collaterals should be adopted.This paper expounds the traditional Chinese medicine(TCM)pathogenesis and treatment of neuropathic pain,enriching the knowledge and providing new ideas for the TCM prevention and treatment of this disease as a collateral disease.
作者
赵禧
施国善
杨舒雯
郭永胜
林培政
王琛
陈鹏
ZHAO Xi;SHI Guoshan;YANG Shuwen;GUO Yongsheng;LIN Peizheng;WANG Chen;CHEN Peng(Tongzhou Maternal and Child Health Hospital,Beijing 101100,China;School of Basic Medicine,Guizhou University of Traditional Chinese Medicine(TCM),Guiyang 550025,China;Accreditation Center of TCM Physician,National Administration of TCM,Beijing 100000,China;First Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Zhujiang Hospital of Southern Medical University,Guangzhou 510405,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第13期197-202,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金青年基金项目(82104658)
贵州省科技计划项目(黔科合基础-ZK[2021]一般544)。
关键词
神经病理性疼痛
络病
久痛入络
络虚则痛
neuropathic pain
collateral disease
chronic pain entering collaterals
deficiency in collaterals inducespain
