王悦芬利下焦治疗糖尿病肾脏疾病  

Wang Yuefen′s Treatment of Diabetic Kidney Disease fromPerspective of Dredging Lower Jiao

作　　者：谢晋 王婉懿 于宗业 李一民 刘梦超 赵文景[2] 王悦芬[2] XIE Jin;WANG Wanyi;YU Zongye;LI Yimin;LIU Mengchao;ZHAO Wenjing;WANG Yuefen(School of Clinical Medicine,Beijing University of Chinese Medicine,Beijing China 100029;Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University,Beijing China 100010)

机构地区：[1]北京中医药大学临床医学院,北京100029 [2]首都医科大学附属北京中医医院,北京100010

出　　处：《中医学报》2024年第4期803-807,共5页Acta Chinese Medicine

基　　金：北京市中医药科技发展资金项目(JJ-2020-46);北京市属医院科研培育计划项目(PZ2022022)。

摘　　要：糖尿病肾脏疾病病机演变与三焦气化失常密切相关,消渴病日久,三焦燥热怫郁、气化失常,因燥致虚,与此同时气血津液等精微物质流变障碍,酿生痰湿、瘀血、浊毒等有形之邪,病理产物凝滞胶结,伏匿于肾络,进一步加重三焦气化障碍,发为本病。临证应用以“宣上焦、畅中焦、利下焦”为核心的“畅三焦”治疗思路。其中利下焦即恢复下焦肾脏气化功能之意,一则祛除痰湿、瘀血、浊毒等干扰肾脏气化之因素;一则补肾益肾提供能量。利下焦可以概括为补益肾元,平调阴阳以补肾气;固肾涩精,敛阴益肾以涩肾精;行气化瘀,活血通络以通肾络;分清泻浊,利水渗湿以泻肾浊,攻补兼施恢复下焦肾脏气化之功。The pathogenesis evolution of diabetic kidney disease is closely related to the abnormal Qi Hua of the triple energizer.When the diabetes lasts for a long time,the triple energizer is hot and dry,causing depression and abnormal Qi Hua.The deficiency is caused by Dryness.At the same time,the circulation of the fine substances such as Qi,blood and body Fluid is blocked,which breeds tangible evil factors such as Phlegm and Dampness,blood stasis and Turbid Toxin.The pathological products are coagulated and cemented,hiding in the kidney collateral,further aggravating the disorder of the triple energizer,and then this disease occurs.The clinical application of the"regulating Three Jiao"treatment concept,with"spersing Upper Jiao,regulating Middle Liao and dredging Lower Jiao"as the core.Among them,dredging Lower Jiao means restoring the function of kidney Qi.On the one hand,it eliminates factors that interfere with kidney Qi,such as Phlegm Dampness,blood stasis and Turbid Toxins;on the other hand,energy is supplied by tonifying kidney.Dredging Lower Jiao can be summarized as tonifying the kidney Yuan Qi,regulating Yin and Yang to replenish kidney Qi as well as consolidating the kidney and astringent the kidney Essence.Promoting Qi and removing blood stasis,promoting blood circulation,and unblocking collaterals to unblock the Kidney meridian;Distinguishing and purging turbidity,promoting diuresis and dampness to clear kidney turbidity,and simultaneously applying the function of attacking and tonifying to restore kidney Qi in the Lower Jiao.

关 键 词：糖尿病肾脏疾病 利下焦 三焦 气化 肾络 肾浊 王悦芬 

分 类 号：R249.27[医药卫生—中医临床基础]