基于络虚有瘀探讨补虚通络法在糖尿病肾病中的运用及展望

Application and prospect of tonifying deficiency for removing obstruction method in diabetes nephropathy based on collateral deficiency and stasis

糖尿病肾病(DN)发病机制、临床表现及病理变化与中医络病理论具有相关性。近年来,依据络病理论治疗和研究DN渐成趋势,结合文献资料、临床实践经验及基础研究,总结本病核心病机为络虚有瘀,以补虚通络为治疗大法。认为补虚当以气血为要,强调通络与化瘀有别。用药当固本培元,重视辛润药物,并注意久病缓攻,通畅络脉。笔者从中医“久病入络”理论阐述DN发病及进展过程,探讨从络论治本病的现状和思考,以期为本病防治提供参考。

The pathogenesis,clinical manifestations and pathological changes of diabetes nephropathy(DN)are related to the collateral disease theory of traditional Chinese medicine.In recent years,treatment and study of DN based on collateral diseases theory has gradually become a trend.Combined with literature,clinical experience and fundamental research,it is summarized that the core pathogenesis of DN is deficiency and stasis of collateral,the treatment method is to tonify deficiency for removing obstruction.It is believed that qi and blood should be taken as the key points in tonifying deficiency,and the difference between unblocking collaterals and removing blood stasis should be emphasized.The prescriptions should attach importance to strengthening healthy energy and Xinrun Tongluo herbs,and pay attention to slow attack and smooth collaterals.This paper expounds the pathogenesis and progress of DN from the theory of‘collateral invasion in chronic sickness’,and discusses the current situation and thinking of treating DN from collaterals,with a view to providing reference for the prevention and treatment of DN.