糖尿病肾脏病内热证证候分布特点研究  

Study on distribution characteristics of traditional Chinese medicine heat syndrome in diabetic kidney disease patients

作　　者：闫润泽 王耀献[2] 王晓娜[1] 王梦迪 高亚斌 孙卫卫[1] YAN Run-ze;WANG Yao-xian;WANG Xiao-na;WANG Meng-di;GAO Ya-bin;SUN Wei-wei(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Beijing University of Chinese Medicine,Beijing 100029,China;Beijing Hospital of Tralitioral Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学,北京100029 [3]首都医科大学附属北京中医医院,北京100010

出　　处：《中华中医药杂志》2020年第8期4153-4156,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：首都卫生发展科研专项项目(No.2016-1-4192)。

摘　　要：目的:探究糖尿病肾脏病(DKD)不同分期内热证的分布特点,以及内热证与其他证素之间的关系。方法:对202例DKD患者进行分层、横断面中医证候调查,对结果进行统计分析。结果:内热证在DKD各期中普遍存在,早期常见的内热证类型为燥热、郁热,内热证常与阴虚证、气虚证结合,热伤气阴;中期内热证主要为结热、湿热,内热常与湿浊、瘀血等病理产物互相胶结,虚证表现逐渐加重,邪正相争,肾络微型癥瘕逐渐形成、发展;晚期内热证主要为浊热、湿热,阳虚证比例明显升高,虚实相兼,寒热错杂,肾元衰败,浊毒次生。结论:内热病机贯穿于DKD的始终,随疾病进展呈不同的表现形式和分布特点,是肾络微型癥瘕形成的始动因素和必备条件。Objective:To investigate the distribution characteristics of heat syndrome and the relationship between heat syndrome and other syndromes.Methods:A layered and cross-sectional survey of TCM syndromes in 202 DKD patients was carried out,and the obtained data were analyzed.Results:Heat syndrome was common in DKD.Heat syndrome in the early stages were dryness-heat syndrome and heat accumulation syndrome,which was widely combined with deficiency of qi and yin.Heat syndrome in middle stages were heat twisting syndrome and dampness heat syndrome,which was intertwined with dampness,turbidity and blood stasis,and easily blocked in the kidney collaterals.Because of the conflict between pathogenic factor and vital qi,the manifestation of deficiency syndrome began to aggravate.The advanced heat syndrome were dampness heat syndrome and dirt heat syndrome.The proportion of yang deficiency syndrome increased significantly and the function of the kidney was decreased significantly.Conclusion:Heat syndrome widespread in the whole course of DKD,showing different manifestations and distribution characteristics with the progress of the disease,and promoted the formation of renal collateral conglomeration.

关 键 词：糖尿病肾脏病 内热证 肾络癥瘕 证候 分布特点 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]