糖尿病肾病“以病统证”思维模式的构建

Construction of the thinking mode of“disease dominating syndrome”in diabetic kidney disease

随着西医学对中医学的不断渗透和结合,中医诊疗模式逐渐从辨证论治为主转变为病证结合为主。但是病证结合模式如何在疾病中应用以提高疗效尚不清楚。基于以上背景,通过论述病证结合模式中“以证统病”和“以病统证”的争鸣,分析了这两种思维模式的应用特点及运用“以病统证”思维模式治疗糖尿病肾病的优势,并介绍了在临床中应用“以病统证”思维模式诊疗糖尿病肾病的过程,即首先识病,确立糖尿病肾病精损络痹的病机,其次通过因病识证来判断糖尿病肾病的“证”,最后针对病靶证靶立法施治。“以病统证”思维模式为临证更加精准地治疗糖尿病肾病、提高疗效提供了新思路。

With the continuous penetration and integration of traditional Chinese medicine(TCM)with Western medicine,the TCM diagnosis and treatment mode has gradually changed from a thinking mode based on syndrome differentiation and treatment to a thinking mode based on the combination of the di-sease and syndrome.However,it is unclear how the disease-syndrome combination model can be applied to disease to improve its efficacy.This article introduces the contention of the two thinking modes of“syndrome dominating disease”and“disease dominating syndrome”in the combination of the disease and syndrome and analyzes the application characteristics of these two modes and the advantages of using the“disease dominating syndrome”thinking mode in the treatment of diabetic kidney disease(DKD).Then,it introduces the process of diagnosing and treating DKD with the thinking mode of“disease dominating syndrome”in clinical practice.That is,first recognize the disease;establish the DKD pathogenesis of essence depletion and the collateral impediment.Second,determine the“syndrome”of DKD by recognizing the disease.Finally,treatment according to the syndrome by the legislation of the disease target and syndrome target.The thinking mode of“disease dominating syndrome”provides a new idea for the more effective clinical treatment of DKD.