叶晓滨

【摘 要】 糖尿病周围神经病变归属于糖尿病（Diabetes mellitus，DM）慢性并发症，影响感觉神经和运动功能，麻木和疼痛是该疾病的典型临床症状。糖尿病周围神经病变（Diabetic peripheral neuropathy，DPN）治疗主要包括控制血糖、减轻神经病痛等对症治疗。化学药物特点是毒副作用大，耐受性差。因此，需要多方面的研究来证明DPN治疗的有效方法。近年来，中医药复杂的化学成分，使之具有多种生物活性、靶点效应和双向调节的优点，副作用少，药物依赖性不明显，对于预防和治疗这类慢性疾病方面的优势得到广泛认可。文章就黄芪及其治疗气虚血瘀证的中成药对于干预DPN作用机制作一综述，旨在为中医药对DPN的治疗提供参考。

【关键词】 黄芪;中成药;气虚血瘀证;DM;DPN

【中图分类号】R587.5 【文献标志码】 A 【文章编号】1007-8517（2021）14-0084-05

Abstract：Diabetic peripheral neuropathy belongs to chronic complications of diabetes mellitus （DM）， affecting sensory nerve and motor function. Numbness and pain are typical clinical symptoms of this disease. The treatment of Diabetic peripheral neuropathy （DPN） mainly includes symptomatic treatment， such as controlling blood sugar and reducing neuropathic pain. The characteristics of the chemical drugs are high side effects and poor tolerance. Therefore， many studies are needed to prove the effective method of DPN treatment. In recent years， due to the complex chemical composition of traditional Chinese medicine， it has the advantages of multiple biological activities， multi-target effects and two-way regulation， less side effects and less drug dependence. Its advantages in the prevention and treatment of such chronic diseases have been widely recognized. In this paper， Astragalus membranaceus and its Chinese patent medicine for the treatment of qi deficiency and blood stasis syndrome for the intervention of DPN mechanism is reviewed， in order to provide a reference for the treatment of traditional Chinese medicine for DPN.

Keywords：Astragalus Membranaceus; Chinese Patent Medicine; Qi Deficiency and Blood Stasis; Diabetes Mellitus; Diabetic Peripheral Neuropathy

最常见的微血管并发症是糖尿病神经病变，DM最常见的慢性并发症是DPN，它是DM所致周围神经和自主神经损伤的一种形式，占全世界所有神经病病例的一半[1]，DPN早期病理改变以小神经纤维损伤为主，之后使糖尿病足溃疡和下肢截肢的病情加速，发病率高，死亡率高，患者生活质量差。当代医家通过临床试验得出DPN的病理环节包含神经微环境破坏与神经营养因子缺乏、微循环障碍和免疫异常等相关因素，现代医学改善DPN病理疼痛的发展主要通过降血糖、降血脂、抗氧化和抗炎作用等症状性治疗来实现，临床治疗效果不乐观。调查研究[2]发现，DPN的发病率增长趋势仍不断上升，干预DPN是目前临床研究重点内容之一。……