仝小林院士治疗糖尿病肾脏疾病大量白蛋白尿期验案1例  

A case report of the treatment of diabetic kidney disease at the stage of macroalbuminuria by Academician Tong Xiaolin

作　　者：谢伟楠 鲍婷婷 黄一珊 张莉莉[1] 赵林华[1] XIE Weinan;BAO Tingting;HUANG Yishan;ZHANG Lili;ZHAO Linhua(Guang,anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学,北京100029

出　　处：《吉林中医药》2022年第5期591-594,共4页Jilin Journal of Chinese Medicine

基　　金：国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-D-202001)。

摘　　要：糖尿病肾脏疾病(diabetic kidney disease,DKD)临床上以持续性白蛋白尿和(或)估算肾小球滤过率(estimated glomerular filtration rate,eGFR)进行性下降为主要特征,是一种较为常见的糖尿病微血管并发症。糖尿病肾脏疾病患者病情进展至大量白蛋白尿期时,由于需要考虑患者的心、肾功能等,使用药物时会受到限制。仝小林院士根据多年临床经验,在“治未病”和“络病”理论指导下,提出该病的核心病机是气虚络瘀,其病理特点为“虚、瘀、浊”,治疗上提倡将益气活血通络贯穿治疗的始终。通过对仝小林院士治疗的1例糖尿病肾脏疾病大量白蛋白尿期的整理分析,总结其临床用方、用量经验。Diabetic kidney disease(DKD)is clinically characterized by the symptom of persistent albuminuria and/or progressive decline in estimated glomerular filtration rate(eGFR),and is a relatively common microvascular complication of diabetes mellitus.As it progresses to the stage of macroalbuminuria,its medication will be subject to some restrictions due to the need to consider the patients’heart and kidney functions.Based on years of clinical experience and under the guidance of the theories of preventive treatment of diseases and collateral diseases,Academician Tong Xiaolin concludes that its core pathogenesis is qi deficiency and collateral stasis,and its pathological characteristics are deficiency,blood stasis,and turbidity.Accordingly,he advocates replenishing qi,activating blood circulations and dredging collaterals throughout the treatment of the disease.This paper reports and analyzes a case of diabetic kidney disease with macroalbuminuria treated by Tong Xiaolin,in a bid to summarize his clinical experience in formulating prescriptions and determining proper dosages.

关 键 词：糖尿病肾脏疾病 大量白蛋白尿期 中医药疗法 经验总结 仝小林 

分 类 号：R587.1[医药卫生—内分泌]