摘要
肌少症是以肌肉量减少,肌肉力量降低以及躯体功能下降为表现的慢性疾病,严重危害老年人的生命健康,糖尿病肾脏病(Diabetic Kidney Disease,DKD)是老年糖尿病患者常见的慢性并发症,研究显示糖肾是罹患肌少症的独立危险因素,且糖肾并发肌少症的老年患者数量不断增加。传统治疗肌少症大多“从脾论治”,疗效有限,《脉决汇辩·脉论》中提出“肾为脏腑之本,十二脉之根”,与脾脏有着先后天互相影响的关系,故从肾论治肌少症亦有理论依据。该文从肾论治糖肾合并肌少症,以“肾为脏腑之本”为立足点,结合现代医学的发病机制,认为肾肾阳虚衰,失于封藏,肾损及脾,脾肾两虚是糖肾合并肌少症的病机。治以补肾为主,配合健脾益气之法,脾肾同治。最后通过吾师的临床医案作为治疗思路,为诊治DKD合并肌少症提供新的方向。
Sarcopenia is a chronic disease characterized by reduced muscle mass,decreased muscle strength,and decreased physical function,which seriously endangers the life and health of the elderly.Diabetic kidney disease(DKD)is a common chronic complication in elderly diabetic patients.Studies have shown that DKD is an independent risk factor for sarcopenia,and the number of elderly patients with DKD complicated with sarcopenia is continuously increasing.Traditional treatment of sarcopenia mostly"treats from the spleen",and the curative effect is meager."The Pulse Decision and Debate.Pulse Theory"proposes that"the kidney is the foundation of viscera and the root of twelve pulses",and it has a relationship of mutual influence between congenital and acquired with the spleen.Therefore,treating sarcopenia from the kidney also has traces to follow.This article treats DKD complicated with sarcopenia from the perspective of the kidney.Taking"the kidney as the foundation of viscera"as the foothold and combining with the pathogenesis of modern medicine,it is believed that yang deficiency of kidney yang,failure to seal and store,kidney damage affecting the spleen,and deficiency of both spleen and kidney are the pathogenesis of DKD complicated with sarcopenia.In treatment,tonifying the kidney should be the main approach,combined with the method of invigorating the spleen and replenishing qi,and treating both the spleen and kidney simultaneously.Finally,through the clinical medical records of my teacher as the treatment idea,it provides a new direction for the diagnosis and treatment of DKD complicated with sarcopenia.
作者
邓新宇
王丽
DENG Xinyu;WANG Li(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《实用中医内科杂志》
2025年第8期60-63,共4页
Journal of Practical Traditional Chinese Internal Medicine
基金
全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。
关键词
糖尿病肾病
肌少症
肾为脏腑之本
病因病机
Diabetic kidney disease
Sarcopenia
Foundation of viscera
Etiology and pathogenesis
