糖尿病肾病病名探源及病机述评

A Review on Origin of Disease's Name and Pathogenesis of Diabetic Nephropathy

文章从古代医家对糖尿病肾病的临床症状描述,对糖尿病肾病的古代病名进行探讨。纵观近代医家对糖尿病肾病的病机研究进展,作者发现随着糖尿病发展至糖尿病肾病,其基本病机也从阴虚燥热发展为气阴两虚,而且贯穿于疾病的始终,后期阴损及阳,阴阳两虚。病位主要在肾,病久损伤肾络,虚损脏腑以脾肾为主,可涉及肝脏。在脏腑气血亏虚的同时,还会产生相应的病理产物,瘀、痰、湿、毒病理因素等同时与虚并存,相互作用产生瘀阻血脉、痰瘀互结、水湿潴留、浊毒内停等标实之病理变化。

In this article, the author discusses the clinical symptoms of diabetic nephropathy（DN） described by ancient physicians. After making a general survey on the research progress about pathogcnesis of DN from modem physicians, the author has found that with the development of diabetes to DN, the basic pathogenesis also changed from Yin deficiency and dryness-heat to deficiency of both Qi and Yin, then running through the whole process of disease. In the late stage of DN, Yin deficiency affects Yang and eventually leading to both Yin and Yang deficiency. The location of the DN has relationship with kidney in Chinese medicine, and prolonged disease enters into kidney collaterals. However, the deficiency of viscera are mainly in spleen, and kidney, involving the liver. Under the deficiency of viscera, Qi and blood, the corresponding pathological factors, such as blood stasis, phlegm, dampness and toxin could be produced,, coexisting with deficiency. They mixes with each other, leading to excess syndromes such as stasis retained in blood vessel, phlegm and blood stasis, dampness retention, stagnation of toxic turbid.