中医杂志

总结艾儒棣教授运用通脉法分期治疗糖尿病足的临证经验。认为糖尿病足以正虚邪侵、湿瘀阻脉为核心病机，其中脾胃亏虚、脉道失荣为发病之本，湿浊挟瘀血稽留脉道为致病之标。诊治过程注重下肢脉诊，通过诊趺阳脉、太溪脉、委中脉判断病情轻重。糖尿病足未溃期以祛湿化瘀为主，寒湿困脉者治以温化寒湿、消壅复脉，内服自拟脱疽1号方，外治以自拟温阳通络方熏洗并涂搽自拟沃雪膏；湿瘀客脉者治以利湿泄热、化瘀通脉，内服自拟脱疽2号方，外治以自拟解毒消肿散熏洗并涂搽自拟五妙膏。糖尿病足已溃期需通补兼施，以养血活血、益气护脉为法，内服自拟脱疽3号方，外撒自拟乳没血竭散并敷贴生肌玉红膏。

This paper summarizes Professor AI Rudi's clinical experience in applying the promoting blood circulation method for staged treatment of diabetic foot. He considers the core pathogenesis of diabetic foot to be deficiency of vital qi with invasion of pathogenic factors, and obstruction of the vessels by dampness and blood stasis. Among these, insufficiency of the spleen and stomach and malnourishment of the vessels are the root causes, while retention of turbid dampness and blood stasis in the vessels represents the secondary manifestation. Diagnosis and treatment emphasize pulse examination of the lower limbs; specifically, assessing the Fuyang pulse （趺阳脉）, Taixi pulse （太溪脉）, and Weizhong pulse （委中脉） to determine disease severity. In the pre-ulcerative stage of diabetic foot, the treatment focuses on dispelling dampness and resolving stasis. For patients with cold-damp obstructing the vessels, the principle is to warm and transform cold-damp, disperse accumulation, and restore vessel patency; the internal treatment uses a self-formulated prescription Tuoju No. 1 Formulation （脱疽1号方）, while the external treatment includes fumigation with the self-prepared Wenyang Tongluo Formulation （温阳通络方） and topical application of the selfprepared Woxue Ointment （沃雪膏）. For patients with damp-heat and stasis obstructing the vessels, the principle is to drain dampness, clear heat, transform stasis, and unblock the vessels; internally administered Tuoju No. 2 Formulation （脱疽2号方）, with external fumigation using the self-prepared Jiedu Xiaozhong Powder （解毒消肿散） and topical application of the self-prepared Wumiao Ointment （五妙膏）. In the ulcerative stage, the principle is to combine unblocking and supplementation, nourishing and activating the blood, tonifying qi, and protecting the vessels. Internally, Tuoju No. 3 Formulation （脱疽3号方） is prescribed; externally, the self-prepared Rumo Xuejie Powder （乳没血竭散） is applied topically, together with Shengji Yuhong Ointment （生肌玉红膏） for wound healing.