Exploring the pathogenesis and treatment of diabetic nephropathy based on the theory of orifices
Diabetic nephropathy belongs to the category of diabetes in traditional Chinese medicine(TCM),which is one of the most important and seriously harmful microvascular complications of diabetes mellitus.It is characterized by microvascular injury,and can affect the whole kidney.It is the main cause of end-stage renal disease,which seriously affects the quality of life and life span of diabetic patients.At present,modem medicine for diabetic nephropathy mainly focuses on life management,blood glucose control and symptomatic treatment,which usually have a series of problems such as high cost,unsatisfactory effect or inconvenience,and bring great burden to patients and their families,so it is urgent to seek safer,more convenient and effective treatment methods.In this paper,diabetic nephropathy is understood from the theory of orifices in TCM.Combined with the origin and connotation of the theory of orifices in TCM,this paper believes that the normal condition of orifices is unobstructed,and explains the occurrence and development of diabetic nephropathy with the theory of orifices in TCM.It is proposed that the basic pathogenesis of diabetic nephropathy is the abnormality of opening and closing of blood orifices,which causes the abnormal operation and excretion of water and dreg orifices.The obstruction of blood orifices causes insufficient nutrition and renal tissue dysfunction,which in turn leads to the disorder of body water and liquid transfusion and metabolism,and the body metabolic waste excretion disorders.Its clinical manifestations include anemia,edema,vomiting,vertigo,and abnormal stool.Adjuvant examination often shows an increase in proteinuria,blood lipids,uric acid,creatinine,urea nitrogen,and a progressive decrease in glomerular filtration rate,which can eventually lead to chronic renal failure with the progression of the disease.It is suggested that the TCM treatment of diabetic nephropathy should be based on the principles of activating blood circulation and unchoking orifices,expending dampness and retained fluid,and promoting defecation to remove turbidity,so as to provide new ideas and methods for the clinical treatment of diabetic nephropathy.
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