糖尿病肾病中医分期辨治的探讨

Discrssion on Staged Syndrome Differentiation and Treatment of Diabetic Nephropathy

中医学认为DN是消渴失治、误治或治之不当,阴虚燥热渐致气阴两虚,痰瘀互结,日久脾肾虚损、毒浊内停而成。糖毒内蕴和瘀血阻络始终贯穿于DN病程的始终,是DN临床各期共同的病机。但DN各期肾脏病理改变有所不同,中医病机亦有各自特点。因此,临床诊治DN时,既要把握DN各期的病机特点,又要抓住其共性,灵活运用滋阴润燥、健脾益气、益肾固精、活血化瘀、泻浊利水诸法,以提高中医药治疗DN的疗效。

It is considered by traditional Chinese medicine that the formation of diabetic nephropathy is due to deficiency of both Qi and yin,accumulation of phlegm and blood-stasis for yin deficiency and dryness-heat,and also due to insufficiency of spleen and kidney and accumulation of toxicity and turbidity after mistreatment,improper treatment or delayed treatment of diabetes mellitus.Accumulation of phlegm and blood-stasis as well as blood-stasis blocking collaterals is the basic pathogenesis of DN during different stages,though the pathogenesis of DN has their differences during different stages.Based on the characteristics of DN pathogenesis,the therapeutic methods for DN should be nourishing yin and moistening dryness,strengthening spleen and activating Qi,supplementing the kidney to control the essence,activating blood and removing stasis,and discharging turbidity and promoting urination.