糖尿病肾脏疾病辨治的难点和临床治疗模式  

Difficulties in the Differentiation and Treatment of Diabetic Kidney Disease and Its Clinical Treatment Model

作　　者：孙卫卫[1,2] 陈荟溪 胡聿昕 郑慧娟 王耀献 SUN Weiwei;CHEN Huixi;HU Yuxin;ZHENG Huijuan;WANG Yaoxian(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700;Beijing University of Chinese Medicine;Henan University of Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院,北京市东城区100700 [2]北京中医药大学 [3]河南中医药大学

出　　处：《中医杂志》2025年第6期575-580,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金区域创新发展联合基金重点支持项目(U22A20237);国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023260);中医药传承与创新“百千万”人才工程(岐黄工程)(国中医药人教发〔2018〕12号)。

摘　　要：糖尿病肾脏疾病(DKD)是引起慢性肾脏病的主要原因之一,中西医在防治DKD方面各有优势,但也存在诸多难点。通过梳理中西医辨治DKD面临的难点,在“肾络微型癥瘕”学说基础上,结合长期临床实践,提出“内热致癥”为DKD核心病机,并基于核心病机构建了DKD“病-证-症”三位一体辨治模式,病、证、症三者是在不同角度对疾病本质的反映,该模式突出了“内热致癥”的核心病机地位。希冀规范DKD的全程治疗,启迪临床。Diabetic kidney disease(DKD)is one of the main causes of chronic kidney disease.Both traditional Chinese medicine(TCM)and western medicine have their own advantages in the prevention and treatment of DKD,but there are also many difficulties.By analysis of the difficulties faced by TCM and western medicine in the differentiation and treatment of DKD,based on the theory of"miniature masses in the renal collaterals",combined with longterm clinical practice,"internal heat leading to mass"is proposed as the core pathogenesis of DKD.Therefore,a trinity model of"disease-syndrome-symptom"for differentiation and treatment of DKD based on the core pathogenesis has been proposed.This model highlights the status of the core pathogenesis of"internal heat leading to mass"in DKD,and conducts a three-dimensional identification from the perspectives of disease,syndrome and symptom,so as to inspire clinical practice.

关 键 词：糖尿病肾脏疾病 内热致癥 辨治模式 

分 类 号：R58[医药卫生—内分泌]