基于“低氧”机制探讨糖尿病肾脏病“壮火食气”的科学内涵

Exploring the Scientific Connotation of“vigorous fire consumes qi”in Diabetic kidney disease Based on“Hypoxia”Mechanism

基于经典中医理论及现有科学研究发现,糖尿病肾脏病中"低氧"机制与"壮火食气"理论存在广泛且深刻的联系。糖尿病肾脏病中壮火内燃、消耗肾气,致肾虚不固、肾体失用,与西医理论中糖尿病高灌注、高滤过、高代谢状态,尤其是肾脏的氧气消耗明显、肾内缺氧通过低氧诱导因子-1α介导蛋白尿、肾功能减退不谋而合,而持续性的低氧进一步通过低氧诱导因子-1α介导肾纤维化同样印证了"因热致癥"理论。基于此,治疗糖尿病肾脏病应注重气火同治、活血消癥,改善糖尿病肾脏病肾内缺氧状态,打断疾病链条,延缓糖尿病肾脏病进展。

Based on traditional Chinese medicine theory and existing scientific research,it is found that the mechanism of“hypoxia”in Diabetic Kidney Disease(DKD)has a broad and profound relationship with the theory of“vigorous fire consumes qi”.In DKD,vigorous fire consumes kidney qi,causes renal dysfunction,and the kidney cannot hold fine substances.It is in accordance with western medicine theory that high perfusion,high filtration,and high metabolic state of diabetes mellitus,the oxygen consumption of the kidney is obvious.Hypoxia coincides with hypoxia-inducible factor(HIF-1α)-mediated proteinuria and renal dysfunction,while persistent hypoxia also confirms“zhengjia caused by heat”theory through HIF-1-mediated renal fibrosis.Based on this,the treatment of DKD should focus on the treatment of both qi and fire,promoting blood circulation,eliminating hypoxia in DKD,interrupting the disease chain,and delaying the progress of DKD.