从“肾藏精”探讨补益肾精法在糖尿病肾病中的应用

糖尿病肾病(diabetic kidney disease,DKD)以阴虚燥热、气阴两虚为基本病机,日久则耗伤人体阴精,"久病必穷肾",且肾又是精气之居所,肾精虚损,"肾藏精"功能失常,无以主津液代谢产生肢体水肿、舌苔厚腻等湿浊内滞之象,无以固摄精微产生蛋白尿、夜尿频多等精不敛固之象,无以化阳助气产生气短乏力、畏寒等阳虚之象,无以充润阴液产生口干、目涩等阴虚之象,故肾不藏精是DKD的核心病机之一。在"肾藏精"理论指导下,补益肾精法为DKD的治疗提供了重要的思路与方法。填补肾精是补益肾精之基石,补气生精是在填补肾精基础上的补充治法,固涩敛精是益精治法之藩篱,通补肾精是益精治法之御守,调摄养精则是益精治法之土壤。补益肾精法环环相扣,内恤外护共达填精、生精、固精、养精之功,肾精之耗损方可恢复。

Application of the Method of Tonifying Kidney Essence in the Treatment of Diebetic Kindney Disease from the Perspective of"Kidney Storing the Essence"

The basic pathogenesis of diabetic kidney disease(DKD)is deficiency of Yin,dryness and heat,deficiency of both qi and yin.Deficiency of both qi and yin will damage the yin essence of human body for a long time,and"long illness will impoverish the kidney".And the kidney is the residence of essence.If the kidney essence is deficient and damaged,the function of"kidney storing essence"is abnormal and can not control the metabolism of body fluid,which will cause signs of dampness and stagnation in the body,such as limb edema,thick and greasy tongue coating,and can′t absorb the essence,which will cause signs of proteinuria,frequent nocturia and other signs of essence,and can′t transform yang and promot qi,which will signs of yang deficiency,such as shortness of breath,fatigue,chills,and so on,and can′t moisten yin fluid,which will signs of yin deficiency,such as dry mouth and astringent eyes.Therefore,kidney not storing essence is one of the core pathogenesis of DKD.Under the guidance of"kidney storing essence"theory,tonifying kidney essence method provides an important idea and method for the treatment of DKD.Tonifying kidney essence is the foundation of tonifying kidney essence,tonifying qi and generating essence is the supplementary treatment based on tonifying kidney essence,astringent and astringent essence is the barrier of tonifying kidney essence,purgation-tonifying kidney essence is the defense of tonifying kidney essence,and regulating and nourishing essence is the soil of tonifying kidney essence.The method of tonifying kidney essence is closely linked with each other.The internal care and external care can achieve the functions of filling essence,generating essence,consolidating essence and nourishing essence.Only when the kidney essence is depleted,can it be recovered.