摘要
糖尿病肾病(DN)是糖尿病常见的微血管病变之一,也是导致糖尿病患者死亡的原因之一。本文从微观出发,发现玄府、肾络与肾脏微观结构的生理病理具有相似之处,燥热怫郁玄府、肾络使玄府开阖失司、肾络瘀滞不通是导致DN发生和发展的关键病机。基于“燥热怫郁-玄府失用-肾络瘀滞”理论,从早、中、晚三期探讨DN的病机及治法:早期热伤气阴,玄府失利,肾络胀满,治以清燥热、益气阴、润玄府;中期痰湿热结,玄府失阖,肾络瘀滞,需侧重除痰湿、通瘀滞、固玄府;晚期浊毒积聚,玄闭络壅,变证丛生,当强调化浊毒、开玄府,并扶正固本。
Diabetic nephropathy(DN)is one of the common microvascular diseases in diabetes mellitus,and one of the causes of death in patients with diabetes mellitus.This article starts from microscopic perspective,finds similarities in physiological and pathological characteristics of xuanfu,kidney collaterals,and microstructure of kidney,stagnation of dry heat to xuanfu,kidney collaterals causes loss of opening and closing in xuanfu,stasis and obstruction of kidney collaterals is key pathogenesis that leads to occurrence and development of DN.Based on the theory of“stagnation of dry heat-dysfunction of xuanfu-stasis of kidney collaterals”,exploring pathogenesis and treatment method of DN from early,middle,and late three stages:in the early stage,heat impairing qi and yin,dysfunction of xuanfu,distention of kidney collaterals,treatment with clearing dry heat,tonifying qi and yin,and moistening xuanfu;in the middle stage,phlegm dampness heat accumulation,failure of xuanfu to close,and stasis of kidney collaterals,emphasis should be placed on eliminating phlegm dampness,removing stasis,and stabilizing xuanfu;in the late stage,accumulation of turbid toxins leads to blockage of xuanfu and congestion of kidney collaterals,resulting in frequent occurrence of various complications,treatment should emphasize eliminating turbid toxins,opening xuanfu,and strengthening and consolidating body resistance.
作者
袁一
于国泳
吴柳青
杨曜铭
颜伃阡
谭清云
黄韬
YUAN Yi;YU Guoyong;WU Liuqing;YANG Yaoming;YAN Yuqian;TAN Qingyun;HUANG Tao(The First Clinical Medical College,Beijing University of Chinese Medicine,Beijing 100700,China;Department of Preventive Medicine,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国医药导报》
2026年第6期113-117,共5页
China Medical Herald
基金
国家自然科学基金资助项目(81874443)
国家中医药管理局第四批全国中医(西学中)优秀人才研修项目(国中医药办人教函〔2019〕64号)。
关键词
燥热怫郁
玄府
肾络
糖尿病肾病
病机
治法
Stagnation of dry heat
Xuanfu
Kidney collaterals
Diabetic nephropathy
Pathogenesis
Treatment method
