糖尿病神经发症的中医外治法.docxVIP

糖尿病神經併發症的中醫外治法的文獻研究SUEN Wing Yee Kammy(孫頴儀)A report submitted for the Degrees ofBachelor of Chinese Medicine andBachelor of Science (Hons) in Biomedical SciencePrincipal Supervisor: Dr. XU DaJiSchool of Chinese MedicineHong Kong Baptist UniversityApril 2014DeclarationI hereby declare that this thesis represents my own work, which has been carriedout after registration for the degrees of BCM and BSc (Hons) in Biomedical Science at the Hong Kong Baptist University, and has not been previously included in a thesis, dissertation submitted to this or other institution for a degree,diploma or other qualification. Signature:__________________ (SUEN Wing Yee Kammy) Date:摘要糖尿病神經性幷發症的中醫外治法的文獻研究糖尿病現今是全球第三位國家醫療負擔及第六位的致死慢性疾病，盛行率可由初期之 7.5% 至 25 年後的50%。是因由高血糖症或血糖升高，不受控制的時候而出現神經系統異常的一種常見的慢性併發症。本文以簡單的解剖分類為三類：肢周圍神經病變、自主神經病變及中樞神經系統病變，由於周圍神經病變的病發率相對較高及外治手法在種類上比其餘兩者多，所以在此會集中對論以周圍神經病變為主的外治手法。肢體周圍神經病變其臨床表現多為肢體末端如腳出現麻木、感覺異常或感覺遲鈍、共濟失調。之後續漸伸延至腿臂等。由於肢體感覺異常，為患者生活上帶來極大困擾及不便。本研究系統評價近年來糖尿病性周圍神經病變的概況，探討此病的學術上及臨床上的共識，整理近十五年學術文獻及碩士博士論文，總結及掌握現今臨床診斷、各外治手法，重點研其優勢所在。研究發現臨床上辨證分型繁多，可綜合成四個證型：寒凝血瘀證、氣虛血瘀證、肝腎虧虛證、痰瘀內阻證，分別以益氣活血化瘀，活血化瘀及溫經通絡的外洗方治療。研究結果亦顯示中醫治療方法中，自擬方作中藥外洗劑較多，而糖痛方外洗佔外洗治療方法的三成半，廣為學者研究，值得進一步推廣應用；而在針灸方面。藥用規律方面，中藥外洗方多選用紅花、桂枝、當歸、川牛膝、川芎及雞血藤；用穴規律中，常用穴位及部位是即多選用地膚子、蛇床子、白鮮皮及苦參。筆者認為本文大治療七大方法均顯示其高有效率，臨床上應規劃出糖尿病神經性併發症統一辨證分型和療效判定標準，充分發揮中醫藥在治療糖尿病神經性併發症的效用。關鍵詞：糖尿病；神經性併發症；周圍神經病變；辨證論治；外治方法SummaryLiterature Study Project of DiabetesNeuropathy Complicationsof Surgery of Traditional Chinese MedicineDiabetes is the third in the world and sixth national health burden of death and chronic disease prevalence by 50% to 7.5% in the 25 years after the initial. Is the cause of hyperglycemia or elevated blood sugar andthe nervous system abnormalities will arise. It classifies intothree categories anatomically: limb peripheral neuropathy, autonomic neuropathy, and central nervous system lesions.Due to the relatively high incidence rates of peripheral neuropathy and more kinds of surgery of traditionalChinese medicine, so I will