蔡圣朝治疗早期糖尿病肾脏疾病临床经验  

Clinical Experience of CAI Shengchao in Treating Early Diabetic Kidney Disease

作　　者：丁诺诺 费爱华[1] 蔡圣朝[1] DING Nuonuo;FEI Aihua;CAI Shengchao(The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China)

机构地区：[1]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《中医药临床杂志》2022年第5期834-838,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：蔡圣朝名医传承工作室(国中医药人教发[2014]20号)。

摘　　要：糖尿病肾病是糖尿病常见的并发症之一,发病率高,预后不良。蔡圣朝教授认为该病病位在脾、肾,病机以气阴亏虚为主,日久形成痰湿、瘀毒等病理产物为其标,治疗上以益气养阴为主,兼以祛湿、化瘀,标本兼治,临床疗效颇佳。糖尿病肾脏疾病(diabetes kidney disease,DKD)是糖尿病(diabetes mellitus,DM)最主要的血管并发症之一,属于中医的“消渴”“水肿”“尿浊”等范畴,西医认为DKD是由环境和遗传因素共同参与的疾病,其发病机制复杂,至今尚未完全阐明,现代研究显示其发病机制包括炎症、氧化应激、糖代谢紊乱、血流动力学异常及细胞因子等多种因素参与。蔡圣朝教授从中医角度认为该病病因当责之“气阴亏虚”为本,以脾肾二脏为主要病变脏腑,日久形成痰湿、瘀毒等病理产物为其标,从而产生水肿、蛋白尿等相应临床症状,治疗上以“益气养阴”为主,兼以祛湿、化瘀之法于其内,标本兼治,临床疗效颇佳。该文总结了国家第五批名老中医蔡圣朝教授运用中医药治疗DKD的临床经验,结合病案对其治疗方法进行病机治则的分析。Diabetic nephropathy is one of the common complications of diabetes with high incidence and poor prognosis.Professor CAI Shengchao believes that the disease is located in the spleen and kidney,and its pathogenesis is mainly due to deficiency of Qi and Yin,with the formation of phlegm-damp,blood stasis and other pathological products as the target over time.Dampness,removing blood stasis,treating both the symptoms and root causes,the clinical effect is quite good.Diabetic kidney disease(DKD)is one of the most important vascular complications of diabetes(diabetes mellitus,DM),which belongs to the categories of“diabetes mellitus”,“edema”and“turbid urine”in traditional Chinese medicine.Western medicine believes that DKD It is a disease caused by both environmental and genetic factors.Its pathogenesis is complex and has not yet been fully elucidated.Modern research shows that its pathogenesis includes inflammation,oxidative stress,glucose metabolism disorders,hemodynamic abnormalities and cytokines and other factors.Participate in perspective of traditional Chinese medicine,Professor CAI Shengchao believes that the cause of this disease is“deficiency of Qi and Yin”,and the spleen and kidney are the main diseased viscera.For the corresponding clinical symptoms such as proteinuria,the treatment is mainly based on“replenishing Qi and nourishing Yin”,as well as the methods of removing dampness and removing blood stasis.This paper summarizes the clinical experience of Professor CAI Shengchao,the fifth batch of famous old Chinese medicine practitioners in the country,using traditional Chinese medicine to treat DKD,and analyzes the pathogenesis of his treatment methods based on medical records.

关 键 词：糖尿病肾脏疾病 中药 针灸 名医经验 蔡圣朝 

分 类 号：R249[医药卫生—中医临床基础]