从《黄帝内经》“通因通用”思想论治糖尿病肾病蛋白尿
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摘要
蛋白尿是糖尿病肾病最突出的临床表现,也是DN进展最危险因素之一。文章根据《黄帝内经》"通因通用"思想,将糖尿病肾病蛋白尿瘀血阻络的成因概括为热燔血瘀、气虚血瘀、气滞血瘀、阳虚寒凝血瘀几大类,治疗大法主要有清热活血化瘀法、益气活血化瘀法、行气活血化瘀法、温阳散寒化瘀法。
Proteinuria is the most prominent clinical manifestations of diabetic nephropathy,which is also one of the most dangerous factors in the progression of diabetic nephropathy.Based on the thought of "treating incontinent syndrome with dredging method" in Huangdi′s Internal Classic,this paper summarizes the causes of blood stasis in diabetic nephropathy proteinuria as follows:exuberant heat and blood stasis,Qi deficiency and blood stasis,Qi stagnation and blood stasis and Yang deficiency and cold coagulation and blood stasis,with the main treatment of clearing heat and activating blood and resolving stasis,boosting Qi and activating blood and resolving stasis,moving Qi and activating blood and resolving stasis,and warming Yang for dispelling cold and resolving stasis.
Proteinuria is the most prominent clinical manifestations of diabetic nephropathy,which is also one of the most dangerous factors in the progression of diabetic nephropathy.Based on the thought of "treating incontinent syndrome with dredging method" in Huangdi′s Internal Classic,this paper summarizes the causes of blood stasis in diabetic nephropathy proteinuria as follows:exuberant heat and blood stasis,Qi deficiency and blood stasis,Qi stagnation and blood stasis and Yang deficiency and cold coagulation and blood stasis,with the main treatment of clearing heat and activating blood and resolving stasis,boosting Qi and activating blood and resolving stasis,moving Qi and activating blood and resolving stasis,and warming Yang for dispelling cold and resolving stasis.
引文
[1] Raij L,Tian R,Wong J S,et al. Podocyte injury:the role of proteinuri-a,urinary plasminogen,and oxidative stress[J]. Am J Physiol Renal Physiol,2016,311(6):F1308-F1317.
[2] de Boer I H,Rue T C,Hall Y N,et al. Temporal Trends in the Prevalence of Diabetic Kidney Disease in the United States[J]. JAMA,2011,305(24):2532-2539.
[3] Liu ZH. Nephrology in China[J]. Nat Rev Nephrol,2013,9(9):523-528.
[4] Jarraya F,Lakhdar R,Kammoun K,et al. Microalbuminuria:a useful marker of cardiovascular disease[J]. Iran J Kidney Dis,2013,7(3):178-186.
[5]葛永纯,谢红浪,徐峰,等.糖尿病肾病微量白蛋白尿患者肾脏组织损伤及病情变化的研究[J].肾脏病与透析肾移植杂志,2015,24(3):207-212.
[6] Douros A,Kauffmann W,Bronder E,et al. Ramipril-induced liver injury:case report and review of the literature[J]. Am J Hypertens,2013,26(9):1070-1075.
[7] Kostapanos M S,Florentin M,Elisaf M S. Fenofibrate and the kidney:an overview[J]. Eur J Clin Invest,2013,43(5):522–531.
[8]代晓颖,张燕,易静,等.中医药降低早期糖尿病肾病患者蛋白尿水平疗效的Meta分析[J].北京中医药大学学报,2016,39(2):144-150.
[9]杨乐斌,项磊,蒋平平,等.芪丹地黄颗粒治疗2型糖尿病肾病的实验研究[J].辽宁中医杂志,2017,6(44):1304-1307.
[10]施学丽,郭超峰,邓小敏,等.桂枝汤方证关系的研究探讨[J].辽宁中医杂志,2016,12(43):2516-2517.
[11]王一,周春祥.以《伤寒论》为纲探析麻黄汤新用[J].中国中医基础医学杂志,2015,9(21):1165-1166.
[12]王付,王林玉.桂枝茯苓丸方证思考与探索[J].中华中医药杂志,2016,31(7):2618-2620.
[2] de Boer I H,Rue T C,Hall Y N,et al. Temporal Trends in the Prevalence of Diabetic Kidney Disease in the United States[J]. JAMA,2011,305(24):2532-2539.
[3] Liu ZH. Nephrology in China[J]. Nat Rev Nephrol,2013,9(9):523-528.
[4] Jarraya F,Lakhdar R,Kammoun K,et al. Microalbuminuria:a useful marker of cardiovascular disease[J]. Iran J Kidney Dis,2013,7(3):178-186.
[5]葛永纯,谢红浪,徐峰,等.糖尿病肾病微量白蛋白尿患者肾脏组织损伤及病情变化的研究[J].肾脏病与透析肾移植杂志,2015,24(3):207-212.
[6] Douros A,Kauffmann W,Bronder E,et al. Ramipril-induced liver injury:case report and review of the literature[J]. Am J Hypertens,2013,26(9):1070-1075.
[7] Kostapanos M S,Florentin M,Elisaf M S. Fenofibrate and the kidney:an overview[J]. Eur J Clin Invest,2013,43(5):522–531.
[8]代晓颖,张燕,易静,等.中医药降低早期糖尿病肾病患者蛋白尿水平疗效的Meta分析[J].北京中医药大学学报,2016,39(2):144-150.
[9]杨乐斌,项磊,蒋平平,等.芪丹地黄颗粒治疗2型糖尿病肾病的实验研究[J].辽宁中医杂志,2017,6(44):1304-1307.
[10]施学丽,郭超峰,邓小敏,等.桂枝汤方证关系的研究探讨[J].辽宁中医杂志,2016,12(43):2516-2517.
[11]王一,周春祥.以《伤寒论》为纲探析麻黄汤新用[J].中国中医基础医学杂志,2015,9(21):1165-1166.
[12]王付,王林玉.桂枝茯苓丸方证思考与探索[J].中华中医药杂志,2016,31(7):2618-2620.