糖尿病肾病脉络病变阐述

Theoretical explanation on choroid lesions in diabetic nephropathy

糖尿病肾病(DN)是糖尿病严重的微血管并发症,从络论治DN,"气阴两虚,络脉瘀阻"为DN基本病机已渐成共识。文章基于脉络学说,认为DN的发生、发展,实质上是消渴病久病不愈,热伤气阴,热结、气滞、痰湿、瘀血相互胶结,积聚于肾之脉络,痼结难去,阻滞气血运行,出现络气郁(虚)滞、脉络瘀阻、脉络瘀塞、络息成积、络虚不荣等病理改变,致肾体受损,肾用失司,导致DN的发生。依据"络以通为用"的原则,DN的治疗倡导益气养阴治其本,祛瘀化痰、通络消积治其标。

Diabetic nephropathy was a serious microvascular complications of diabetes, the consensus was that treatment was based on collateral disease theory, DN basic pathogenesis was qi-yin deficiency and obstruction of collaterals. Based on choroids theory, we proposed that the occurrence and development of DN was the delay and the improper treatment of diabetes, which leaded the injury of the yin and qi, the cementation of the sputum, yu, heat and blood stasis in the kidney choroids. So there occurred choroids lesions： stagnation of qi in choroids, obstruction of choroids, stasis of choroids, mass obstruction of choroids. Based on the principle of ＇luo yi tong wei yong＇, the methods should be supplementing qi, nourishing yin and activating blood circulation and getting rid of phelegm stagnation.