糖尿病肾病早期中医病机解析
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摘要
糖尿病肾病因高发病率及致残率引起越来越多的学者重视,中药治疗介入糖尿病肾病早期可逆转病程发展,文章整理和总结辽宁省名中医专家马晓燕教授对糖尿病肾病早期的病机分析,指出气阴两虚是糖尿病肾病发生的内在基础;瘀血内阻是贯穿于糖尿病肾病始终的一种主要病理变化;而气阴两虚兼血瘀则是糖尿病肾病早期的病变要妙。针对糖尿病肾病早期病机,又提出益气养阴活血法是治疗糖尿病肾病早期最重要且行之有效的方法。
More and more scholars pay attention to diabetic nephropathy due to its high incidence and disability rate. Chinese medicine can reverse the course of disease in the early stage of interventional diabetic nephropathy. This paper summarizes professor MA Xiaoyan,a famous expert of traditional Chinese medicine in Liaoning province,on the early pathogenesis of diabetic nephropathy. It is pointed out that deficiency of Qi and Yin is the internal basis for the occurrence of diabetic nephropathy. Internal obstruction of blood stasis is a major pathological change throughout diabetic nephropathy. The deficiency of Qi and Yin and blood stasis are the early changes of diabetic nephropathy. In view of the early pathogenesis of diabetic nephropathy,the method of replenishing Qi,nourishing Yin and activating blood circulation is the most important and effective method for the treatment of early diabetic nephropathy.
More and more scholars pay attention to diabetic nephropathy due to its high incidence and disability rate. Chinese medicine can reverse the course of disease in the early stage of interventional diabetic nephropathy. This paper summarizes professor MA Xiaoyan,a famous expert of traditional Chinese medicine in Liaoning province,on the early pathogenesis of diabetic nephropathy. It is pointed out that deficiency of Qi and Yin is the internal basis for the occurrence of diabetic nephropathy. Internal obstruction of blood stasis is a major pathological change throughout diabetic nephropathy. The deficiency of Qi and Yin and blood stasis are the early changes of diabetic nephropathy. In view of the early pathogenesis of diabetic nephropathy,the method of replenishing Qi,nourishing Yin and activating blood circulation is the most important and effective method for the treatment of early diabetic nephropathy.
引文
[1]中华医学会糖尿病学分会糖尿病慢性并发症调查组.全国住院糖尿病患者慢性并发症及其相关危险因素10年回顾性调查分析[J].中国糖尿病杂志,2003,11(4):232-237.
[2]钱荣立.加强对糖尿病慢性并发症的防治研究[J].中国糖尿病杂志,2003,11(4):231.
[3]徐灵胎.徐灵胎医书全集[M].太原:山西科学技术出版社,2001:391.
[4]吕仁和,赵进喜,王越.糖尿病肾病临床研究述评[J].北京中医药大学学报,1994,7(2):2.
[5]赵进喜,邓徳强,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.
[6]田风胜,苏秀海,王元松.糖尿病肾病中医病名规范化研究[J].中华中医药杂志,2009,24(11):1424-1426.
[7]张蕾,刘旭生.糖尿病肾病中医病名源流探索性研究[J].辽宁中医杂志,2012(1):52-54.
[8]吕仁和,时振声.糖尿病肾病的中医诊治[J].北京中医,1989,8(2):8-10.
[9]熊曼琪,苗理平.加味桃核承气汤对糖尿病鼠肾超微结构的影响[J].中国医药学报,1990,5(5):25-27.
[10]高彦彬,易京红.中医药辩治糖尿病肾病100例临床分析[J].中医杂志,199l,32(7):31.
[11]赵怡蕊.芪术汤治疗糖尿病肾病的疗效观察[J].中国中西医结合肾病杂志,2006,7(4):230-231.
[12]孙雨濛.孙伟教授治疗糖尿病肾病IV期的临床经验总结[J].中医学报,2016,31(5):660-662.
[13]林兰.中西医结合糖尿病学[M].北京:中国医药科技出版社,1999:395-407.
[14]郑亚萍,刘春杰.赤芍对早期糖尿病肾病大鼠肾脏AngⅡ、ET-1、PKC及TGF-β1的影响[J].当代医学,2012,18(23):20-22.
[15]杨丽珍.中西医结合治疗糖尿病肾病38例疗效观察[J].新中医,1998,30(9):11-13.
[16]肖相如.肾病中的瘀血[J].辽宁中医杂志,2003,30(2):85.
[17]高彦彬,吕仁和,王秀琴,等.糖肾宁治疗糖尿病肾病的临床研究[J].中医杂志,1997(38):96-99.
[18]李明,玉小强,张华.参芪地黄汤治疗早期糖尿病肾病临床研究[J].中医学报,2015(8):1116-1118.
[19]高春雨,黄晓.参芪地黄汤加减治疗气阴两虚型中早期糖尿病肾病体会[J].医学美学美容旬刊,2014(3):54.
[20]林恵武,林燕琼.参芪地黄汤联合缬沙坦在气阴两虚型早期糖尿病肾病中的应用分析[J].光明中医,2016,31(24):3650-3652.
[21]刘烨,马晓燕.肾衰饮对慢性肾功能衰竭大鼠肾脏bmp-7、pdgf、timp-1 mRNA表达的影响[J].中华中医药学刊,2017,35(6):1127-1130.
[22]刘烨,马晓燕.肾衰饮对慢性肾功能衰竭大鼠ATF6/CHOP通路的作用研究[J].中国中医急症,2017,26(5):768-770.
[23]马晓燕,闫渊,崔峥.肾衰饮对TGF-β1诱导的下游因子CTGF及FN的调控作用[J].中华中医药学刊,2015,33(7):745-748.
[24]吴雪静,孟令宇,赵沙沙,等.2型糖尿病发生糖尿病肾病的相关危险因素探讨[J].河北联合大学学报:医学版,2016(6):458-461.
[25]林杏娟.2型糖尿病合并早期糖尿病肾病的相关危险因素分析[J].当代医学,2013,3(20):5-6.
[2]钱荣立.加强对糖尿病慢性并发症的防治研究[J].中国糖尿病杂志,2003,11(4):231.
[3]徐灵胎.徐灵胎医书全集[M].太原:山西科学技术出版社,2001:391.
[4]吕仁和,赵进喜,王越.糖尿病肾病临床研究述评[J].北京中医药大学学报,1994,7(2):2.
[5]赵进喜,邓徳强,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.
[6]田风胜,苏秀海,王元松.糖尿病肾病中医病名规范化研究[J].中华中医药杂志,2009,24(11):1424-1426.
[7]张蕾,刘旭生.糖尿病肾病中医病名源流探索性研究[J].辽宁中医杂志,2012(1):52-54.
[8]吕仁和,时振声.糖尿病肾病的中医诊治[J].北京中医,1989,8(2):8-10.
[9]熊曼琪,苗理平.加味桃核承气汤对糖尿病鼠肾超微结构的影响[J].中国医药学报,1990,5(5):25-27.
[10]高彦彬,易京红.中医药辩治糖尿病肾病100例临床分析[J].中医杂志,199l,32(7):31.
[11]赵怡蕊.芪术汤治疗糖尿病肾病的疗效观察[J].中国中西医结合肾病杂志,2006,7(4):230-231.
[12]孙雨濛.孙伟教授治疗糖尿病肾病IV期的临床经验总结[J].中医学报,2016,31(5):660-662.
[13]林兰.中西医结合糖尿病学[M].北京:中国医药科技出版社,1999:395-407.
[14]郑亚萍,刘春杰.赤芍对早期糖尿病肾病大鼠肾脏AngⅡ、ET-1、PKC及TGF-β1的影响[J].当代医学,2012,18(23):20-22.
[15]杨丽珍.中西医结合治疗糖尿病肾病38例疗效观察[J].新中医,1998,30(9):11-13.
[16]肖相如.肾病中的瘀血[J].辽宁中医杂志,2003,30(2):85.
[17]高彦彬,吕仁和,王秀琴,等.糖肾宁治疗糖尿病肾病的临床研究[J].中医杂志,1997(38):96-99.
[18]李明,玉小强,张华.参芪地黄汤治疗早期糖尿病肾病临床研究[J].中医学报,2015(8):1116-1118.
[19]高春雨,黄晓.参芪地黄汤加减治疗气阴两虚型中早期糖尿病肾病体会[J].医学美学美容旬刊,2014(3):54.
[20]林恵武,林燕琼.参芪地黄汤联合缬沙坦在气阴两虚型早期糖尿病肾病中的应用分析[J].光明中医,2016,31(24):3650-3652.
[21]刘烨,马晓燕.肾衰饮对慢性肾功能衰竭大鼠肾脏bmp-7、pdgf、timp-1 mRNA表达的影响[J].中华中医药学刊,2017,35(6):1127-1130.
[22]刘烨,马晓燕.肾衰饮对慢性肾功能衰竭大鼠ATF6/CHOP通路的作用研究[J].中国中医急症,2017,26(5):768-770.
[23]马晓燕,闫渊,崔峥.肾衰饮对TGF-β1诱导的下游因子CTGF及FN的调控作用[J].中华中医药学刊,2015,33(7):745-748.
[24]吴雪静,孟令宇,赵沙沙,等.2型糖尿病发生糖尿病肾病的相关危险因素探讨[J].河北联合大学学报:医学版,2016(6):458-461.
[25]林杏娟.2型糖尿病合并早期糖尿病肾病的相关危险因素分析[J].当代医学,2013,3(20):5-6.