基于五脏体用的消渴肾病“脾虚肾实”病机刍议  

Preliminary discussion on pathogenesis of‘spleen deficiency and kidney solidity'in diabetes nephropathy based on five organs'body-function

作　　者：杨晗 陈锐[2] YANG Han;CHEN Rui(College of Traditional Chinese Medicine,Changchun University of Chinese Medicine,Changchun 130117,China;College of Basic Medical Sciences,Changchun University of Chinese Medicine,Changchun 130117,China)

机构地区：[1]长春中医药大学中医学院,长春130117 [2]长春中医药大学基础医学院,长春130117

出　　处：《中华中医药杂志》2024年第9期4711-4714,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：吉林省科学技术厅重点研发项目(No.20220204054YY)。

摘　　要：基于五脏体用观可将消渴肾病的病机归纳为脾的体虚用实,肾的体实用虚。文章基于理论讨论和前期研究,中西医互参,阐述了消渴肾病“脾虚肾实”的病机内涵及“瘀、虚、损、毒”四期消渴肾病辨证下的病机发展,认为“苦酸制甘”理论治疗消渴肾病当发扬为“酸苦辅辛制甘”,认为临床长期广泛应用的胰岛素或许可被认为是“制甘”路径之一纳入临床及理论研究中,为实验研究提供新思路。Based on the five organs'body-function perspective,the pathogenesis of diabetic nephropathy can be summarized as the deficiency of the spleen's body with repletion of its function,and the repletion of the kidney's body with deficiency of its function.This paper based on theoretical discussions and preliminary research,integrates traditional Chinese and Western medicine,elucidating the pathogenic connotations of'spleen deficiency and kidney solidity'in diabetic nephropathy and the development of the disease mechanism under the syndrome differentiation of the four stages of'stasis,deficiency,damage,and toxicity'.It suggests that the theory of‘bitter and sour restraining sweet'should be developed into'restraining sweet with sour and bitter supplemented by pungent'in the treatment of diabetic nephropathy.Paper also considers that insulin,which has been widely used in clinical practice for a long time,could be regarded as one of the'restraining sweet'approaches to be included in clinical and theoretical research,providing new ideas for experimental studies.

关 键 词：消渴肾病 糖尿病肾脏疾病 五脏体用观 脾虚肾实 苦酸制甘 酸苦辅辛制甘 

分 类 号：R277.5[医药卫生—中医学] R255.4