摘要
糖尿病肾病(diabetic nephropathy,DN)是长期慢性高血糖导致血糖升高、血脂紊乱等代谢失衡迁延及肾的微血管并发症。糖尿病与日俱增的高发病率,使DN成为导致终末期肾脏病的首位致病因素。近年来随着DN中医病因病机研究的深入,国内专家对DN病因病机把握愈明晰。中医将“辨病-辨证-辨症”三位一体相结合,基于整体观念和辨证论治优势准确把握DN病因病机的基础上辨证施治,使用中医药治疗取得显著疗效。而中医药取得显著疗效的关键在于对疾病病因病机的准确把握。对DN深入研究发现,近年来其病因病机较为标准、客观观点包括气阴两虚说、脾肾亏虚说、肾络瘀阻说、毒损肾络说、伏风扰肾说。本文综合评述前人观点,对DN病因病机综合整理归纳,进一步挖掘评述,以期建立统一疗效评价指标,提高临床疗效,为DN中医临床诊疗提供新的思路。
Diabetic nephropathy(DN)is a microvascular complication of kidney with long-term chronic hyperglycemia,which leads to the increase of blood glucose,dyslipidemia and other metabolic disorders.The increasing high incidence of diabetes makes DN become the first pathogenic factor leading to end-stage renal disease.In recent years,with the deepening of the research on the etiology and pathogenesis of DN in traditional Chinese medicine,domestic experts have a clearer grasp of the etiology and pathogenesis of DN.Traditional Chinese Medicine(TCM)combines the triunity of"differentiation of disease and syndrome",based on the whole concept and the superiority of syndrome differentiation,and on the basis of accurately grasping the etiology and pathogenesis of DN,the treatment with TCM has achieved remarkable curative effect.The key to the remarkable curative effect of traditional Chinese medicine lies in the accurate grasp of the etiology and pathogenesis of diseases.In recent years,it has been found that the etiology and pathogenesis of DN are relatively standard and objective,view points include deficiency of both Qi and Yin,deficiency of spleen and kidney,stagnation of kidney and collaterals,poison damage of kidney collaterals,and excessive wind disturbance of kidney.This paper comprehensively reviews the previous views,comprehensively arranges and summarizes the etiology and pathogenesis of DN,and further excavates and comments,in order to establish a unified efficacy evaluation index,improve the clinical efficacy,and provide new ideas for the clinical diagnosis and treatment of DN in traditional Chinese medicine.
作者
马锋锋
范增慧
MA Fengfeng;FAN Zenghui(The Second Affiliated Hospital of the People's Liberation Army Air Force Military Medical University,Xi'an 710038,China)
出处
《中国中医基础医学杂志》
CAS
CSCD
北大核心
2022年第8期1373-1377,共5页
JOURNAL OF BASIC CHINESE MEDICINE
基金
国家自然科学基金面上项目(82074383)-从外泌体mRNA介导的系膜细胞-足细胞串话探讨糖尿病肾病足细胞焦亡机制及通络益肾方的干预研究
国家自然科学基金面上项目(81774288)-通络益肾中药通过调控线粒体“自噬稳态失衡-凋亡”改善糖尿病肾病足细胞损伤的作用机制研究
国家自然科学基金面上项目(81473671)-从“肾主骨”“脾肾相关”探讨通络益肾法对糖尿病肾病足细胞骨架重排和线粒体功能机制。
关键词
糖尿病肾病
病因病机
述评
Diabetic Nephropathy
Etiology and pathogenesis
Research progress
作者简介
马锋锋(1991-),男,陕西商洛人,硕士研究生,从事心脑血管疾病的中西医结合临床与研究。;通讯作者:范增慧(1992-),女,西安人,助理研究员,硕士研究生,从事经方辨治慢性肾病的中医药临床与研究,Tel:18292922891,E-mail:912129020@qq.com。
