消渴病肾病辨证论治框架研究
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摘要
通过整理秦汉至明清的中医著作,总结"消渴病肾病"因机证治诊疗理论框架。病因包括内因、外因。外因为六淫,内因包括先天不足、不良生活习惯、忧思郁怒。本病病机以脾肾亏虚为主,日久脾肾阳衰,瘀毒内停,发展为本虚标实、虚实夹杂之病机。辨证分为辨病位和辨虚实。治疗以调养脾肾为要,兼以降浊化瘀等法。中医学对于"消渴病肾病"认识较完善,在诊疗方面存在诸多优势。该文通过研究古籍,总结其框架规律,为中医临床诊疗该病提供理论依据。
Tased on TCM works in pre-Qin and Han Dynasties,this paper studied and summarized the treatment of"wasting-thirst disease secondary to nephropathy"to form a theoretical framework. Exogenous diseases refer to the six climatic exopathogens,internal diseases refer to three aspects such as inadequate natural endowment,bad habits and melancholy. Bad habits refer to people who lead a gluttonous,alcoholic,licentious,drug addict,forwearied or fragile lifestyle. Deficiency of spleen and kidney is the basis of pathogenesis for"wasting-thirst disease secondary to nephropathy",long term renal failure and internal toxin will result in edema,obstruction and rejection,etc. Symptom differentiation means distinguish disease's location and deficiency and excess. Disease mainly locates in the kidney and spleen. In the early and middle stage,it showed mainly spleen Qi deficiency and kidney Yin deficiency,when long term Yin deficiency reached Yang would showed Yang deficiency,even asthenia of Qi and blood. The disease's quality is deficiency mixed with excess,deficient root with overdo superficial. The treatment would be focused on spleen and kidney attendance,coupled with method of dispersing blood stasis and descending the turbid. Based on a quite perfect understanding of"wasting-thirst disease secondary to nephropathy",TCM has formed a complete treatment theory with many advantages. This paper studied the related theory in traditional TCM works to summarize their pattern,hoping to provide theoretical reference for TCM clinical diagnosis and treatment of"wasting-thirst disease secondary to nephropathy".
Tased on TCM works in pre-Qin and Han Dynasties,this paper studied and summarized the treatment of"wasting-thirst disease secondary to nephropathy"to form a theoretical framework. Exogenous diseases refer to the six climatic exopathogens,internal diseases refer to three aspects such as inadequate natural endowment,bad habits and melancholy. Bad habits refer to people who lead a gluttonous,alcoholic,licentious,drug addict,forwearied or fragile lifestyle. Deficiency of spleen and kidney is the basis of pathogenesis for"wasting-thirst disease secondary to nephropathy",long term renal failure and internal toxin will result in edema,obstruction and rejection,etc. Symptom differentiation means distinguish disease's location and deficiency and excess. Disease mainly locates in the kidney and spleen. In the early and middle stage,it showed mainly spleen Qi deficiency and kidney Yin deficiency,when long term Yin deficiency reached Yang would showed Yang deficiency,even asthenia of Qi and blood. The disease's quality is deficiency mixed with excess,deficient root with overdo superficial. The treatment would be focused on spleen and kidney attendance,coupled with method of dispersing blood stasis and descending the turbid. Based on a quite perfect understanding of"wasting-thirst disease secondary to nephropathy",TCM has formed a complete treatment theory with many advantages. This paper studied the related theory in traditional TCM works to summarize their pattern,hoping to provide theoretical reference for TCM clinical diagnosis and treatment of"wasting-thirst disease secondary to nephropathy".
引文
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[2]赵进喜,邓德强,李靖.糖尿病肾病相关中医病名考辨[J].南京中医药大学学报,2005,21(5):288.
[3]秦景明.症因脉治[M].上海:上海卫生出版社,1958.
[4]朱丹溪.丹溪心法[M].北京:中国中医药出版社,2008.
[5]张介宾.景岳全书[M].广州:广东科技出版社,1984.
[6]巢元方.诸病源候论[M].北京:人民卫生出版社,1982.
[7]叶天士.临证指南医案[M].上海:上海科学技术出版社,1959.
[8]王肯堂.证治准绳[M].上海:上海科学技术出版社,1959.
[9]陈士铎.辨证录[M].北京:中国中医药出版社,2007
[10]沈金鳖.杂病源流犀烛[M].北京:中国中医药出版社,1994.
[11]丹波元坚.杂病广要[M].北京:中医古籍出版社,2002.
[12]赵佶.圣济总录[M].上海:上海科学技术出版社,2016.
[13]窦材.扁鹊心书[M].北京:中国中医药出版社,2015.
[14]王焘.外台秘要[M].北京:中国医药科技出版社,2011.
[15]唐荣川.血证论[M].北京:中国中医药出版社,1996.
[16]高鼓峰.医宗己任编[M].北京:学苑出版社,2011.
[17]林珮琴.类证治裁[M].北京:中国中医药出版社,2008.
[18]程文囿.医述[M].北京:安徽科技出版社,1983.
[19]徐春甫.古今医统大全[M].北京:人民卫生出版社,1991.
[20]李用粹.证治汇补[M].上海:上海卫生出版社,1958.
[21]喻昌.医门法律[M].上海:上海科技出版社,1959.