摘要
糖尿病肾病(diabnephrathy,DN)是糖尿病临床的微血管并发症之一,也是导致糖尿病患者死亡的重要原因之一,临床表现为蛋白尿、水肿、高血压和肾功能进行性损伤等症状。
在祖国医学中,糖尿病肾病既属“消渴病”范畴,又属“肾病”范畴,故被称为“消渴病肾病”。DN发病隐匿,发病机制复杂,预后较差。早期糖尿病肾病是控制糖尿病肾病发展的重要阶段,积极有效地治疗可以逆转尿蛋白和减少终末期肾病的发生。目前西医治疗仅局限于降糖、降压、调脂、抗凝等方法,但是仍然存在药物疗效不确定、价格昂贵等问题。近年来,祖国医学有关糖尿病肾病的中医辨证论治研究越来越深入。继承和发扬祖国医学“治未病”的思想,早期发现、及时实施干预治疗,对于控制、延缓DN的发生、发展,提高DN患者的生活质量具有重大而深远的意义。
一直以来,吾师用古籍经典开启诊疗思路,用临床实践验证中医经典,并能熟读方书,活用方药,特别是能应用中西医结合疗法改善DN患者的临床症状、降低各项生化指标、保护肾脏以控制病情发展等方面取得一定的疗效。
Diabetes nephrosis (diabnephrathy, DN) is one of diabetes clinical capillaries complications, also causes one which of substantial clauses the diabetic dies, the clinical manifestation for the albuminuria, dropsy, hypertension and the kidney function carries on symptoms and so on damage.
In the motherland medicine, diabetes nephrosis both are“diabetes”the category, and is“the nephrosis”the category, therefore is called“diabetes nephrosis”. The DN morbidity concealment, the pathogenesis is complex, the prognosis is bad. The early diabetes nephrosis is controls diabetes nephrosis development the crucial stage, treats effectively positively may reverse the urine protein and the reduced finally last stage nephrosis occurrence. At present the doctor practicing western medicine treats only limits in falls methods and so on sugar, voltage dropping, accent fat, antifreeze, but still had the medicine curative effect not definite, the price expensive and so on questions. In recent years, the motherland medicine related diabetes nephrosis's Chinese medicine diagnosis and treatment research was getting more and more thorough. Inherits and carries forward the motherland medicine“governs has not gotten sick”the thought that the early discovery, the prompt implementation intervention treatment, regarding the control, delays DN the occurrence, the development, improves the DN patient's quality of life to have significant and the profound significance.
Since continuously, my teacher with the ancient book classics opening diagnosing and treating mentality, with the clinical practice confirmation Chinese medicine classics, and could be familiar with the side book, applies flexibly the side medicine, specially can improve the DN patient's clinical symptoms using the cooperation of Chinese and Western medicine therapy, reduce each biochemistry target, to protect the kidney to control aspects and so on condition development to obtain certain curative effect.
引文
[1]Evans J,Goldfine D,Maddux B A,et a1.Oxidative stress and stress actived signaling pathways:a unifying hypothe-sis of type 2 diabetes[J].EndocrRev,2002,23(5):599-622.
[2]刘俊伏,赵勇军,李军伟等.早期糖尿病肾病预防及治疗研究进展[J].医学研究与教育.2010,27(2):83-85.
[3]彭万年,罗仁.糖尿病肾病研究[M].北京.中国科学技术出版社.2006:30-31.
[4]李平,谢院生.糖尿病肾病中西医结合基础与临床[M].上海.上海科学技术出版社.2009:332-355.
[5]陶毅,张军,李晨.韩乐兵治疗糖尿病肾病的经验[J].湖北中医杂志.2007.29(7):24.
[6]翁苓,张丽霞.周国英主任治疗糖尿病肾病的经验总结[J].福建中医药.2005.36(6):14.
[7]赵迪.高彦彬教授治疗糖尿病肾病学术思想和经验[J].中医研究.2007.20(1):42-44.
[8]张先闻.陈以平辨治糖尿病肾病经验撷要[J].上海中医药杂志.2008.42(6):6-7.
[9]孙爱英.中医药治疗糖尿病肾病的经验谈[J].中国中医药现代远程教育.2010.8(10):74-75.
[10]王秀珍.健脾固肾汤治疗早期糖尿病肾病40例[J].浙江中医杂志.2004,3(98):322.
[11]刘春傅,孟爱霞,黄吉峰.李显筑教授治疗糖尿病肾病经验[J].长春中医药大学学报.2009,25(1):25-26.
[12]丁学屏.糖尿病肾病的中医治疗[M].上海:上海中医药大学出版社,1998.214.
[13]南征.消渴肾病(糖尿病肾病)研究[M].长春:吉林科学出版社.2001.3.
[14]任爱华,阚方旭.糖尿病肾三焦辨治[J].山东中医杂志.2000.19(6):328.
[15]陈以平.邓跃毅.黑料豆丸治疗肾病综合征低蛋白症107例疗效观察[J].上海中医药杂志,1999,33(11):18-19.
[16]罗月中.叶任高教授治疗糖尿病肾病的经验[J].中国中西医结合肾病杂志.2001.2(8):438-440.
[17]顾刘宝,万毅刚.大黄治疗糖尿病肾病的分子细胞机制研究进展.中国中药杂志,2003,28(8):703-705.
[18]王战建,王书畅.冬虫夏草治疗糖尿病肾病的作用机制研究进展[J].中国中西医结合肾病杂志,2008,9(1):88-90
[19]陈杭军,余毅.银杏叶提取物辅助治疗早期糖尿病肾病的疗效[J].广东医学,2006,27(2):235-236.
[20]窦连军,冯林美,徐秀云.黄芪注射液对早期糖尿病肾病患者尿内皮素的影响[J].中国中西医结合杂志,2000,20(3):215—216.
[21]戈娜,李顺民,孙惠力等.地龙对糖尿病肾病大鼠肾脏保护作用的研究[J].上海中医药杂志,2010,44(6):103--105