从“气络-血络”分期论治糖尿病肾病  

Treatment of Diabetic Kidney Disease by Stage from Perspective of"Qi Collateral and Blood Collateral"

作　　者：桑永浩 宋立群[2] 代丽娟[2] SANG Yonghao;SONG Liqun;Dai Lijuan(Heilongjiang University of Traditional Chinese Medicine,Harbin Heilongjiang China 150040;The First Affiliated Hospital to Heilongjiang University of Traditional Chinese Medicine,Harbin Heilongjiang China 150036)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150036

出　　处：《中医学报》2024年第12期2529-2532,共4页Acta Chinese Medicine

基　　金：黑龙江省中医药管理局科研项目(ZHY2020-127);黑龙江省博士后面上资助项目(LBH-Z20095);宋立群全国名老中医药专家传承工作室建设项目{国中医药人教函[2022]75号};第七批全国老中医药专家学术经验继承工作继承人项目{国中医药人教函[2022]76号}。

摘　　要：糖尿病肾病早期多因气络失和,气滞肝络,内蕴化火,灼劫肾阴而致使机体呈现气阴两虚的状态;中期由虚致瘀,致血络不通,瘀阻胃络;晚期气血阴阳俱虚,络脉空虚,无力抗邪,痰瘀化毒,损伤肾络。临床诊治糖尿病肾病可基于“气络-血络”构建新型辨证体系,以糖尿病肾病不同时期发病机制作为切入点分期论治,早期发病以气络失和为先导,治疗应以顺为畅,辅以滋阴;中期发病以气阴亏虚为基础,治疗应以通为用,配以虫药;晚期气血阴阳俱虚,痰瘀浊毒互结,治疗应以辛为泄,辛润通络。Diabetic kidney disease in the early stage is mostly due to Qi and collateral disharmony,stagnation of Qi and Yin in Liver collateral induced internal Fire burning the Kidney Yin and leads to the state of Qi and Yin deficiency;in the middle stage of the disease,the deficiency induced stasis resulting in the blood collateral blockage and stasis stagnation in the Stomach collateral;in the late stage of diabetic kidney disease,deficiency of Qi and blood as well as that of Yin and Yang induced emptiness of collaterals,which is unable to resist the evil factors.Phlegm and stasis stagnation transforms into Toxin and damages the Kidney collaterals.Clinical diagnosis and treatment of diabetic kidney disease can be based on"Qi and blood collaterals"to build a new type of identification system,by exploring the pathogenesis of diabetic kidney disease in different periods as an entry point for staged treatment,with early onset of diabetic kidney disease with Qi and blood collaterals out of harmony as a precursor,the treatment aim is to smooth the Qi and blood flow,supplemented by nourishing Yin;the onset of the middle stage of the disease is Qi and Yin deficiencies and the treatment should dredge the medication,with insect drugs in prescriptions.In the late stage of diabetic kidney disease,both Qi and blood as well as Yin and Yang are deficient,and Phlegm,stasis,Turbidity and Toxin conjugate with each other,so the treatment should be drain them with pungent drugs since drugs with pungent and moist character can dredge the collaterals.

关 键 词：糖尿病肾病 “气络-血络” 分期论治 

分 类 号：R255.4[医药卫生—中医内科学]