从“气络虚、血络瘀”论治糖尿病肾脏病  

Treating Diabetic Kidney Disease Based on Theory of"Deficiency in Qi Collateral and Stasis in Blood Collateral"

作　　者：周吉 祝然然 王子晨 阴永辉[2] 王海燕[1] ZHOU Ji;ZHU Ranran;WANG Zichen;YIN Yonghui;WANG Haiyan(The Eighth People′s Hospital of Qingdao City,Qingdao Shandong China 266121;The Affiliated Hospital to Shandong University of Traditional Chinese Medicine,Jinan Shandong China 250014;The Integrative Medicine Hospital of Jinan City,Jinan Shandong China 271100)

机构地区：[1]青岛市第八人民医院,山东青岛266121 [2]山东中医药大学附属医院,山东济南250014 [3]济南市中西医结合医院,山东济南271100

出　　处：《中医学报》2025年第5期982-985,共4页Acta Chinese Medicine

基　　金：山东省自然科学基金面上项目(ZR2021MH088);山东省自然科学基金项目(ZR2015HL107);青岛市医药卫生科研计划项目(2021-WJZD109)。

摘　　要：气阴两虚是糖尿病转变为糖尿病肾脏病的发病基础,肾络包括气络和血络,是肾维持生理功能的重要组成,气阴两虚导致肾络损伤是糖尿病肾脏病发生的根本病机。在气阴两虚基础上,糖尿病肾脏病早期是以肾“气络虚损”为主;晚期随着湿、热、痰、瘀等病理产物加入又出现以“血络瘀”为主的病机变化,而早期、晚期两种病机皆存在,只是病机侧重有所不同,邪气由气络向血络传变,体现糖尿病肾脏病功能失调发展为器质性病变的特点。临证早期应在补气络基础上,佐以通络,晚期在祛除瘀、痰、湿、热、毒的同时,顾护络气。Deficiency of Qi and Yin is the basis of diabetes mellitus into diabetic nephropathy.The renal collateral includes Qi collateral and blood collateral,and it is an important component of the Kidney to maintain physiological function.Qi and Yin deficiency leading to renal collateral damage is the underlying pathogenesis of diabetic nephropathy.On the basis of the deficiency of Qi and Yin,diabetic nephropathy in the early stage is dominated by the Qi collateral deficiency of Kidney;in the late stage,with the addition of pathological products such as Dampness,Heat,Phlegm and blood stasis,the pathogenesis of diabetic nephropathy is dominated by the stasis in blood collateral.Actually,both pathologies are present in the early stage and the late stage,in which they differ in their status.The Evil Factors passes from Qi to blood,reflecting the dysfunction of diabetic nephropathy and the development of organic lesions.In the early stage of diabetic nephropathy,we should supplement the Qi and blood collaterals with the help of opening the collaterals,and in the late stage,we should take care of the Qi in collaterals while removing the stasis,Phlegm,Dampness,Heat and Toxin.

关 键 词：糖尿病肾脏病 络病理论 气络虚 血络瘀 肾络 

分 类 号：R259.92[医药卫生—中西医结合]