益气养阴清热法治疗糖尿病肾脏病早期蛋白尿研究进展  

Research Progress of the Treatment of Proteinuria in Early Stage of Diabetic Kidney Disease by Replenishing Qi and Nourishing Yin and Clearing Heat

作　　者：孙嘉兴 田瑞娜 周悦欣 朱琳[1] 安晓飞[1] SUN Jia-xing;TIAN Rui-na;ZHOU Yue-xin;ZHU Lin;AN Xiao-fei(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210029)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《河南中医》2022年第12期1921-1927,共7页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82074359);全国西学中骨干人才培训项目专项基金项目(2019-44)。

摘　　要：糖尿病肾脏病(diabetic kidney disease,DKD)的基本病机为本虚标实,早期以气阴两虚、肝肾亏虚为本,阴虚燥热为标,内热为其病理因素,益气养阴清热法可减轻DKD早期蛋白尿和肾脏损伤,并有效延缓DKD患者病情进展。临床治疗DKD早期蛋白尿常用中药有黄芪、山药、地黄和黄蜀葵花等,具有益气养阴或清热功效。DKD早期不断升高的蛋白尿水平可导致肾功能逐渐下降,并迅速进展至DKD后期的肾功能衰竭。在中医“未病先防、既病防变、已病防传”的理论指导下,在西医规范化治疗的基础上应用中医益气养阴清热法,可降低DKD患者早期蛋白尿的水平和肾脏损伤程度,并可改善患者临床症状,提高生活质量,对防治DKD病情的持续进展有重要临床意义。The basic pathogenesis of diabetic kidney disease(DKD)is deficient root cause and excessive manifestation.In the early stage,qi-yin deficiency,and liver-kidney insufficiency are the root causes,while deficiency of yin and dry heat are manifestations.Internal heat is the pathological factor.The method of replenishing qi and nourishing yin and clearing heat can reduce proteinuria and kidney damage in the early stage of DKD and effectively delay the progress of DKD patients.The commonly used Chinese medicinals for clinical treatment of early proteinuria of DKD include Huangqi(Radix Scutellariae),Shanyao(Rhizoma Dioscoreae),Dihuang(Radix Rehmanniae),Huangshukuihua(Abelmoschus Manihot),etc.,which have the effect of replenishing qi and nourishing yin or clearing heat.The increasing proteinuria level in the early stage of DKD can lead to the gradual decline of renal function,and rapidly progress to renal failure in the late stage of DKD.Under the guidance of the TCM theory of"treating disease before its onset,controlling development of existing disease,prevention of transmission after recurrence,"and on the basis of standardized treatment of Western medicine,the application of the method of replenishing qi,nourishing yin and clearing heat of TCM can reduce the level of proteinuria and the degree of kidney damage in the early stage of DKD patients,improve the clinical symptoms,enhance the quality of life,and have important clinical significance for the prevention and treatment of the continuous progress of DKD.

关 键 词：糖尿病肾脏病 益气养阴清热法 蛋白尿 

分 类 号：R259[医药卫生—中西医结合]