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陈志强分期辨治糖尿病肾脏疾病经验

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糖尿病肾脏疾病是糖尿病最主要的微血管并发症之一.其中,"虚"和"瘀"是糖尿病肾脏疾病的主要中医病理机制,也是推动糖尿病肾脏疾病进展的主要病理因素;瘀血和湿热既是糖尿病肾脏疾病的一种病理产物,也是导致糖尿病肾脏疾病进一步发展恶化的重要因素.陈志强教授认为气虚血瘀络阻是贯穿于糖尿病肾脏疾病全程的主体病机,故而,益气活血通络法是贯穿于糖尿病肾脏疾病治疗始终的基本治法.但是,由于糖尿病肾脏疾病发展过程中所处阶段不同,其具体病理改变也不尽相同,除主体病机外,在不同阶段又常叠加着其他的病理改变.因此,在治疗糖尿病肾脏疾病过程中,在把握主体病机的同时,根据其所处的不同时期,本着"有者求之,无者求之,盛者责之,虚者责之"的原则,灵活施治,才能显著提高临床疗效.
CHEN Zhiqiang'experience in treating diabetic kidney disease by stages treatment
Diabetic kidney disease is one of the most important microvascular complications of diabetes.Among them,'deficiency'and'stasis'are the main pathological mechanisms of diabetic kidney disease in traditional Chinese medicine,they are also the main pathological factor to promote the progression of diabetic kidney disease.Blood stasis and damp heat are pathological products of diabetic kidney disease,they are also important factor leading to the further development and deterioration of diabetic kidney disease.Professor CHEN Zhiqiang believes qi deficiency,blood stasis and collateral obstruction are the main pathogenesis throughout the whole course of diabetic kidney disease,therefore,boost qi invigorate blood tongluo method is the basic treatment throughout the treatment of diabetic kidney disease.However,due to diabetic kidney disease in the development process of different stages,the specific pathological changes are not the same.In addition to the main pathogenesis,other pathological changes are often superimposed at different stages.Therefore,the main pathogenesis should be grasped in the treatment of diabetic kidney disease,at the same time,according to the different periods of the disease,flexible treatment is based on the principle of'the one who asks for it,the one who does not ask for it,the one who is responsible for it,and the one who is responsible for it'.In this way,the clinical efficacy can be significantly improved.

Stages treatmentDiabetic kidney diseaseExperienceCHEN ZhiqiangDeficiencyStasisMain pathogenesisObjective pathogenesis

边东、王兴华、高玉伟、马赟、田小超、刘利飞、赵炳武、杨帆

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河北省中医院,石家庄 050011

河北省脾肾病证中医治疗技术创新中心,石家庄 050011

河北医科大学第一医院,石家庄 050030

河北医科大学第二医院,石家庄 050000

河北中医药大学,石家庄 050091

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分期辨治 糖尿病肾脏疾病 经验 陈志强 主体病机 客体病机

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子:1.135
ISSN:1673-1727
年,卷(期):2024.39(12)