高继宁从“肝风扰肾”分期辨证治疗糖尿病肾病经验  

Gao Jining′s Experience in Treatment of Diabetic Nephropathy by Stages from “Liver Wind Harassing the Kidney”

作　　者：陈阳 尹聪 高继宁 CHEN Yang;YIN Cong;GAO Ji-ning(Department of Nephrology,Shanxi Hospital of Integrated Traditional and Westem Medicine,Taiyuan Shanxi 030024;Shanxi Univesity of Chinese Medicine,Taiyuan Shamxi 030024)

机构地区：[1]山西省中西医结合医院肾病科,山西太原030024 [2]山西中医药大学,山西太原030024

出　　处：《世界中西医结合杂志》2023年第1期57-61,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：山西中医药大学高氏肾病学术流派传承工作室项目(2020PY-LP-10);山西中医药大学科技创新能力培训计划(2021PY-JC-02);山西省2021年研究生创新项目(2021Y733)。

摘　　要：系统总结高继宁教授治疗糖尿病肾病的经验。肝为罢极之本,秉少阳生生之气,有耐受疲劳之能;高继宁教授据长期临床实践,认为糖尿病肾病有“忌外感,怕劳累”的发病特点;认为本病病位主要在肝肾,并与冲脉相关。以冲脉血虚为起病之因,肝风扰肾为发病之本,并贯穿始终。早期因冲脉失涵,挟肝风上袭咽喉而有消渴;中期因肝风开泄肾之气络,下盗肾水,致肾失封藏而生蛋白尿;晚期因肝风肆虐肾之血络,肾络血瘀,浊毒内生而有水肿;治疗上强调分期论治,有的放矢。早期荣血调冲以息风,则冲脉不逆,肝风不作;中期镇肝通络以息风,则肝风自息;晚期遵“肾者,胃之关也”之理,化瘀通腑以息风,则邪去正安。文章旨在阐明高继宁教授基于“肝风扰肾”分期治疗糖尿病肾病经验,以资借鉴。This study aimed to systematically summarize Professor Gao Jining′s experience in the treatment of diabetic nephropathy(DN).The liver serves as the root of tolerance to fatigue and holds the vital qi of Shaoyang to resist fatigue.In light of long-term clinical practice, Professor Gao Jining believes that DN has the characteristics of“afraid of exogenous pathogenic factors and fatigue”.It is believed that this disease is mainly located in the liver and the kidney and is related to the thoroughfare vessel.Blood deficiency in the thoroughfare vessel is the cause of the disease, and the liver wind harassing the kidney is the root of the disease, which runs through the whole process.In the early stage, due to the loss of nourishment in the thoroughfare vessel, the liver wind attacks the throat, resulting in wasting thirst disorder.In the middle stage, due to the release of qi collaterals in the kidney by the liver wind, the kidney water was affected, causing kidney dysfunction in storing and producing proteinuria.In the late stage, there was edema due to blood stasis in the collaterals of the kidney and turbid toxin resulting from liver wind ravaging the blood collaterals of the kidney.The treatment by stages with a clear target should be highlighted.In the early stage, the therapeutic principles of nourishing blood and regulating the thoroughfare vessel to extinguish wind are adopted to improve the reversal of the thoroughfare vessel and the raging of liver wind.In the middle stage, the therapeutic principles of settling the liver and dredging collaterals are adopted to extinguish liver wind.In the late stage, since “the kidney serves as the switch of the stomach”,the therapeutic principles of resolving stasis and relaxing bowels to extinguish wind are adopted to expel pathogens.This study aimed to introduce Professor Gao Jining′s experience in the treatment of DN by stages based on “liver wind harassing the kidney” for reference.

关 键 词：糖尿病肾病 高继宁 肝风扰肾 名医经验 冲脉 镇肝息风 通腑泻浊 活血通络 

分 类 号：R587.2[医药卫生—内分泌]