基于“湿邪”分期论治糖尿病肾病  

Staged Treatment of Diabetic Kidney Disease Based on"Dampness Pathogen"

作　　者：王恺 卞陈晨 安晓飞[1] WANG Kai;BIAN Chenchen;AN Xiaofei(Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing,Jiangsu,China,210029)

机构地区：[1]南京中医药大学附属医院,江苏省中医院,江苏南京210029

出　　处：《河南中医》2024年第5期670-675,共6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(2019-44)。

摘　　要：糖尿病肾病病因多有饮食不洁、情志内伤、素体肾虚;病机多属本虚标实,脾肾亏虚为本,湿瘀浊毒为标,湿邪贯穿糖尿病肾病始终。根据湿邪在糖尿病肾病中不同的表现将糖尿病肾病分为四期进行论治:早期湿热内生,宜化湿清热养阴;中期湿瘀阻络,宜利湿化瘀通络;晚期湿浊泛滥,宜降浊解毒扶正;末期湿毒内聚,宜降浊解毒扶正。糖尿病肾病不同阶段邪正对比存在明显差异,当根据各期证候特点进一步研究不同化湿药的应用指征、用量及用法,正本清源,动态观察,提升用药精准性,使化湿不伤阴,补虚不滞邪。The etiology of diabetic kidney disease(DKD)mostly includes unclean diet,emotional internal injury,and constant kidney deficiency.The pathogenesis mostly belongs to deficient root cause and excessive manifestation.The deficiency of the spleen and kidney is the root,and the dampness,blood stasis and turbid toxin are the root.The dampness pathogen runs through DKD all the time.Accord⁃ing to the different manifestations of dampness in DKD,DKD treatment can be divided into four stages:In early stage when endogenous dampness heat occurs,the treatment should focus on resolving dampness,clearing heat and nourishing yin.In the middle stage,damp⁃ness and blood stasis blocks the meridians,and it is advisable to drain dampness,remove blood stasis,and unblock the meridians.In the late stage,there is excessive dampness and turbidity,and it is advisable to reduce turbidity,detoxify,and strengthen healthy qi.In the late stage,there is dampness and toxin accumulation,it is also advisable to reduce turbidity,detoxify,and strengthen healthy qi.There are obvious differences in the comparison of pathogenic factors and heathy qi in different stages of DKD.It is necessary to further study the application indications,dosage and usage of different dampness⁃resolving drugs according to the characteristics of the syndromes in each stage in order to find out the source of dampness,make dynamic observation,improve the accuracy of drug use,so as to eliminate dampness without damaging yin,and supplement deficiency without stagnating pathogenic factors.

关 键 词：糖尿病肾病 湿邪 辨证论治 分期论治 

分 类 号：R259[医药卫生—中西医结合]