养阴活血法在糖尿病肾病中的应用体会

Application Experience of Nourishing Yin and Activating Blood Circulation Method in The Treatment of Diabetic Kidney Disease

糖尿病肾病属于中医学“消渴”范畴,中医理论认为阴虚、血瘀是糖尿病肾病病机的主要部分。笔者认为在糖尿病肾病进展中,阴虚、血瘀两者呈动态变化。早期阴虚重而瘀血轻,中期阴虚和瘀血兼重,后期阴虚弱而瘀血重,同时变生他证。因此对于糖尿病肾病的诊治根据病情侧重将其分为三期,以养阴活血为主,兼顾变证。在糖尿病肾病早期为阴虚燥热、瘀血内生之证,治宜养阴清热为主、和血为辅;中期为气阴两虚、肾络瘀阻之证,治宜滋阴活血并重兼以益气;晚期为阴阳两虚、瘀血阻络之证,治宜滋阴助阳、破血通络。

Diabetic kidney disease can be attributed to the category of"Xiaoke"in traditional Chinese medicine.Yin deficiency and blood stasis are the main parts of the pathogenesis of diabetic kidney disease in TCM theory.The author believes that Yin deficiency and blood stasis exhibit dynamic changes in the progression of diabetic kidney disease.Yin deficiency plays a more important role in the early stage,but in the middle stage,Yin deficiency and blood stasis are both important,and in the late stage,the blood stasis is more important than Yin deficiency while other syndromes occur.Therefore,the treatment of diabetic kidney disease can be divided into three phases according to the severity of the disease,but the treatment is mainly based on nourishing Yin and activing blood circulation.In the early stage of diabetic kidney disease,it is a syndrome of Yin deficiency and dryness-heat accompanied with blood stasis.It is suitable for nourishing Yin and clearing heat,and supplemented by activing blood circulation.In the middle stage,it is a syndrome of Qi and Yin deficiency accompanied with blood stagnation in kidney meridian.It is suitable for nourishing Yin and activing blood circulation,and supplemented by invigorating Qi.In the late stage,it is a syndrome of Yin and Yang deficiency accompanied with blood stasis in collaterals.It is suitable for nourishing Yin and Yang,and supplemented by remoring blood stasis and dredging collaterals.