2型糖尿病性肾病病案1例——仝小林院士教学查房实录

Teaching ward round transcript on type 2 diabetic nephropathy case by Academician Tong Xiaolin

仝小林院士提出糖尿病单元化管理,旨在面对糖尿病合并多个并发症时,整合医院多个学科,更好地为患者制定最优的个性化诊治方案。本文以广州中医药大学深圳医院(福田)内分泌科一例2型糖尿病性肾病患者为例,通过邀请多学科专家讨论及仝小林院士教学查房,对2型糖尿病性肾病的中医辨治思路、疾病发展、诊治要点进行阐述。强调辨别脾瘅与消瘅肾病的异同及糖尿病治疗全程化瘀通络的重要性;当患者症状复杂、合并多个并发症时,处方用药要把握中医辨治重点,抓住核心态靶;本案介绍了糖尿病肾病的辨治经验,提倡掌握方药量效关系,更好地发挥中药治疗疾病的优势。

Academician Tong Xiaolin proposes the unit management of diabetes mellitus,which aims to integrate multiple disciplines of the hospital when diabetes mellitus is complicated with multiple complications,so as to better develop optimal personalized diagnosis and treatment programs for patients.Taking a case with type 2 diabetic nephropathy in the Department of Endocrinology,Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine as an example,this article expoundes the thinking of traditional Chinese medicine(TCM)treatment based on syndrome differentiation,disease development,and the key points of diagnosis and treatment of type 2 diabetic nephropathy by inviting multidisciplinary experts to discuss and Academician Tong Xiaolin to make a teaching ward round.This paper emphasizes the importance of distinguishing the similarities and differences between Pi-dan and Xiao-dan nephrosis,and the importance of expelling blood stasis and removing obstruction in collaterals in the whole course of treatment of diabetes mellitus.When patients have complex symptoms and multiple complications,the prescription medication should focus on the key points of TCM treatment based on syndrome differentiation,and grasp the core state target.This paper also introduces the experience of treatment based on syndrome differentiation of diabetic nephropathy,and advocates to master the relationship between the dosage and effect of prescriptions and drugs,so as to better leverage the advantages of traditional Chinese medicine in treating diseases.