仝小林院士缓解1型糖尿病肾病进展验案1则  

A case of Academician Tong Xiaolin delaying the progression of type 1 diabetic nephropathy

作　　者：杨浩宇 谢伟楠 韦宇 周凌 高泽正 YANG Haoyu;XIE Weinan;WEI Yu;ZHOU Ling;GAO Zezheng(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China;Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学,北京100029 [3]青岛大学附属医院,山东青岛266003

出　　处：《吉林中医药》2024年第8期928-931,共4页Jilin Journal of Chinese Medicine

基　　金：中国中医科学院广安门医院临床医学研究中心建设专项(2022LYJSZX01)。

摘　　要：1型糖尿病肾病可由于其初始血糖高,进展迅速,其治疗侧重控制血糖和蛋白尿,以延缓肾脏损伤进展。仝小林院士将糖尿病肾病病因病机归纳为“虚、瘀、浊”,虚是始动因素,瘀是全程表现,浊是最终结局,并指出“瘀”贯穿整个糖尿病肾病全过程,在治疗时应“全程通络”。本验案患者从2017年确诊糖尿病肾病Ⅲ期后,于仝小林院士门诊规律就诊,从2020年11月至今,患者24 h尿蛋白定量稳定在100 mg/24 h以下,未再升高到异常值。治疗过程中,仝小林院士根据患者病情的变化调整方剂,补气活血通络,缓解微血管损伤。现将总结医案,望对1型糖尿病肾病的治疗提供参考。As type 1 diabetic nephropathy can progress rapidly due to its high initial blood glucose,its treatment usually focuses on controlling blood sugar and proteinuria to slow down the progression of kidney damage.Academician Tong Xiaolin categorizes the etiology and pathogenesis of diabetic nephropathy into"deficiency,stasis,and turbidity",where deficiency is an initiating factor,while stasis is a constant manifestation throughout the course,and turbidity is the ultimate outcome,highlighting that"stasis"permeates the entire course of diabetic nephropathy,and the disease should be treated by"unblocking collaterals throughout the entire course".After being diagnosed with Stage III diabetic nephropathy in 2017,the patient regularly visited Academician Tong Xiaolin's clinic.From November 2020 to the present,the patient's 24-hour urinary protein has remained stable below 100 mg/24h,without rising to the abnormal level again.During the treatment,Academician Tong Xiaolin adjusted prescriptions according to the changes in the patient's condition,and relieved microvascular damage by benefiting qi,promoting blood circulation,and removing obstruction in collaterals.The paper presents a summary of the medical case,hoping to provide some insights into the treatment of type 1 diabetic nephropathy.

关 键 词：糖尿病肾病 补气活血通络 水蛭 仝小林 

分 类 号：R587.2[医药卫生—内分泌]