从黄元御“一气周流”理论论治糖尿病肾病

Treatment of Diabetic Nephropathy Based on Huang Yuanyu′s Theory of"One Qi Circulation"

“一气周流”是黄元御《四圣心源》中“土枢四象,一气周流”理论的主要概括,简洁而完美地阐释了中医天人合一理念的精髓。糖尿病肾病是糖尿病最常见的并发症之一,消渴日久,易转为水肿、蛋白尿等肾系疾病。该病病机与五脏密切相关,五脏任何一脏出现异常均可诱发,只有五脏协调和畅,才能气血阴阳平衡。根据“一气周流”理论,治疗糖尿病肾病时,不但需要中焦脾土的斡旋,也需要左右肝肺气机平衡,更需要上下心肾水火既济,各脏腑、气血、阴阳相匹配,方可达五脏安和。故临证时可从中土斡旋、升降畅达,肝木升发、疏泄气机,肾水温养、水火既济等角度治疗糖尿病肾病。

"One Qi circulation"is the main summary of Huang Yuanyu′s theory of"Earth being the pivot of other Four Elements,and one Qi circulation all around body"in his works of Si Sheng Xin Yuan.It succinctly and perfectly explains the essence of the concept of unity between heaven and man in traditional Chinese medicine.Diabetes nephropathy is one of the most common complications of diabetes.After a long period of the disease,it is easy for patients to suffer from edema,proteinuria and other Kidney related diseases.The pathogenesis of this disease is closely related to the Five Zang.Any abnormality in the Five Zang can induce it.Only when the Five Zang are coordinated and unobstructed can the balance of Qi,blood,Yin and Yang be achieved.According to the theory of"one Qi circulation,the treatment of diabetes nephropathy requires not only the mediation of the Middle Jiao,the Spleen being the Earth,but also the Qi movement balance of left and right,the Liver Qi and Lung Qi,and more importantly,the combination of Water and Fire in the upper and lower,the Heart and Kidney.In other words,the perfect matching of the Qi and blood,Yin and Yang can achieve the peace of the five Zang.Therefore,we can treat diabetes nephropathy from the perspectives of Spleen mediation,smooth Qi ascending of Liver and descending of Lung,nourishing Kidney Water and balancing Water and Fire.