从脾肾亏虚论治糖尿病肾病

Treatment of Diabetic Nephropathy From Spleen and Kidney Deficiency

文章系统总结了糖尿病肾病的临床治疗经验。糖尿病肾病相当于中医的消渴肾病,其基本病机为脾肾两虚为本,痰湿血瘀为标,治疗上以补脾益肾为总的治疗原则,并根据标实的不同兼以化痰祛湿、活血化瘀。同时根据脾肾两脏亏虚程度的差异以及标实的不同,将本病分为早期、中期、晚期进行辨证论治。早期为脾气亏虚,拟用方药补中益气汤,并据标实程度酌加芳香化湿及活血化瘀之品;中期为脾肾两虚,方用四君子汤合六味地黄丸加减,并据痰湿及瘀血的存在酌加祛痰湿及活血化瘀类药物,同时注重补肝肾强腰脊;晚期以肾虚为主、浊毒内停、气血阴阳衰败为主,拟用方药为实脾散合金匮肾气丸,并根据兼证的不同酌加相应药物以对症治疗,临床取得较好疗效。

The clinical treatment experience of diabetic nephropathy is summarized in this paper. Diabetic nephropathy is equivalent to the traditional Chinese medicine of diabetes nephropathy. The basic pathogenesis is spleen and kidney deficiency for this, phlegm and blood stasis. The treatment to supplement the spleen and tonifying the kidney is the general principles of treatment, and according to the standard of different phlegm - dampness, promoting blood circulation to remove blood stasis. At the same time, according to the difference of deficiency of spleen and kidney and the difference of the two viscera, the disease is di- vided into early, middle and late stages. Early of spleen deficiency intends to receive Buzhong Yiqi Decoction and according to degree adding aromatic and promoting blood circulation to remove blood stasis drugs ; mid deficiency of both the spleen and kidney, Sijunzi Decoction and Liuwei Dihuang Pill, and according to the existence of phlegm and blood stasis adding phlegm - dampness and promoting blood circulation and removing blood stasis drugs. At the same time pay attention to nourishing liver and kidney; late stage kidney deficiency, Qi, blood, Yin and Yang decline and intends with Jinkui Shenqi Pill, and according to the different actions with corresponding drugs to symptomatic treatment and has a better clinical curative effect.