基于毒伏肾络病机探讨糖尿病肾脏病的防治  

Exploration of the Prevention and Treatment of Diabetic Kidney DiseaseBased on the Pathogenesis of Toxin Hidden in Kidney Collaterals

作　　者：于淼[1] 王秀阁[1] 赵芸芸[1] 王国强[1] YU Miao;WANG Xiu-Ge;ZHAO Yun-Yun;WANG Guo-Qiang(The Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021 Jilin,China)

机构地区：[1]长春中医药大学附属医院,吉林长春130021

出　　处：《广州中医药大学学报》2023年第7期1815-1818,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:82274456);吉林省科技发展计划项目基础研究项目(编号:YDZJ202201ZYTS187);吉林省科技发展计划项目重点研发项目(编号:20200404045YY);长春中医药大学科学研究发展基金(培育基金)项目(编号:2019023)。

摘　　要：从毒伏肾络的病机角度探讨糖尿病肾脏病的防治,涵盖了毒邪、伏邪、络病学、未病先防等中医理论。毒伏肾络理论可高度概括糖尿病肾脏病的核心病机,较毒损肾络理论更能体现糖尿病肾脏病病机的动态变化,整合了治疗中未病先防、既病防变的思想,即在糖尿病发生时就需调护阴阳气血,扶正固本,以防邪蕴成毒,伏匿于肾络;及至糖尿病肾脏病发生时,更要既病防变,益气固精,扶正以祛邪,减少毒的进一步产生及壮大。基于毒伏肾络病机防治糖尿病肾脏病更契合临床实际。据此可拟定解毒通络保肾、益气固精除伏毒为糖尿病肾脏病的治疗总则,并且随着疾病的进展、病情的演变、正虚与邪实所占比重的变化以及针对疾病的不同阶段,具体治法需有所侧重。The thoughts for the prevention and treatment of the diabetic kidney disease(DKD)from the perspective of the pathogenesis of toxin hidden in kidney collaterals cover the traditional Chinese medicine(TCM)theories of toxic pathogen,latent pathogen,collateral disorders and prevention of aggravation after disease.The theory of toxin hidden in kidney collaterals highly summarizes the core pathogenesis of DKD,which is better on reflecting the dynamic changes in the pathogenesis of DKD than the theory of toxin injuring kidney collaterals.The thoughts for the prevention and treatment of the DKD from the perspective of the pathogenesis of toxin hidden in kidney collaterals embody the ideas of prevention before illness and prevention of aggravation after disease during the treatment,i.e.,on the onset of diabetes,therapies of regulating yin,yang,qi and blood can be used to supporthealthy qi and consolidate the constitution,so as to prevent pathogen from becoming toxin and being hidden in thekidney collaterals;when DKD occurs,it is crucial to prevent the aggravation after disease,and the therapies oftonifying qi and consolidate essence,supporting healthy qi to eliminate pathogens can be adopted to reduce thefurther production and growth of toxin. From the perspective of the pathogenesis of toxin hidden in kidneycollaterals, the prevention and treatment of DKD is more practical in the clinic. Therefore, the therapeuticprinciple for DKD can be formulated as the method of removing toxin and unblocking collaterals to protect kidney,and replenishing qi and consolidating essence to removing hidden toxin,and the detailed ways will be varied withthe progression and the evolution of the illness, in the changes of predominance of healthy- qi deficiency orpathogenic-qi excess,and in different stages.

关 键 词：糖尿病肾脏病 毒损肾络 毒伏肾络 解毒通络 益气固精 

分 类 号：R256.5[医药卫生—中医内科学]