论熟地黄在糖尿病肾脏病治疗中的应用

Application of Shudihuang(Radix Rehmanniae Praeparata) in the Treatment of Diabetic Kidney Disease

糖尿病肾脏病以阴精亏损、肾络痹阻为核心病机,其中阴精亏损贯穿疾病全程,早期以肾阴亏虚为主,中后期以肾精虚损为要。熟地黄为滋阴填精要药,可有效针对糖尿病肾脏病阴精亏损的核心病机进行治疗。糖尿病肾脏病中后期肾之阴精亏损较重,可出现肾气、肾阳、营血亏虚等证,加之因虚留滞,常致痰饮、瘀血等病理产物痹阻肾络。熟地黄不仅可发挥养血逐痹的作用,还能通过配伍他药达到祛滞填精、积气生精、求阴中阳、纳气平喘、消肾虚痰的效果。此外强调熟地黄在糖尿病肾脏病治疗中应谨防滋腻碍胃之弊,同时需掌握滋阴填精之度,以防纠偏过甚。

To verify the effect and safety of mobixustion rigorously,it is on the premise that the sham moxibustion is designed in a reasonable way.This paper summarized the current situation of sham moxibustion design in clinical trials by analyzing the problems in terms of blinding difficulty,insufficient safety precautions and lack of safety evaluation,and discussed the necessity of setting sham moxibustion.It is concluded that current sham moxibustion cannot control the unique physical and chemical effects of moxibustion,and the standardization is insufficiency regardless of the varied moxibustion forms.The high awareness of moxibustion among the public makes another difficulty and challenge to hide the sham moxibustion.Based on the different types of moxibustion,such as moxa stick moxibustion,cone moxibustion,indirect moxibustion,warming-needle moxibustion,and moxibustion with moxa burner,three methods have been proposed in the design of sham moxibustion,which are controlling the physical and chemical effect of burning moxa,changing the moxibustion materials,and controlling the burning degree of moxa,in order to improve the methodological quality of moxibustion clinical trials,and promote the standardization and scientificity of trial design.