王小琴分期论治糖尿病肾病经验管窥

糖尿病肾病是导致终末期肾病的首要病因，王小琴教授运用中医理论诊治糖尿病肾病取得较好的效果。王小琴教授认为本虚标实为本病的中医核心病机，本虚为脾肾亏虚，标实为热毒、水湿、痰浊、瘀血，脉络瘀阻贯穿疾病始终。总治则为补肾健脾、祛瘀通络，早期以养阴益气，补肾填精为主，常以参芪地黄汤加减；中期在扶正固本基础上，针对兼症辨证论治，如无明显浮肿，则以补中益气汤加减，如浮肿伴大量蛋白尿，常选用实脾饮加减；晚期以益肾健脾，调和阴阳，化湿泄浊为主，常以补肾泄浊之肾元颗粒联合自拟益气健脾、活血泄浊方加减治疗。文章归纳总结了王小琴教授运用经方加减分期论治糖尿病肾病的独特辨治经验。

Introduction to Wang Xiaoqin’s experience in treating diabetic nephropathy by stages

Diabetic nephropathy is the primary cause of end-stage renal disease. Professor Wang Xiaoqin has achieved good results in the treatment of diabetic nephropathy with the theory of traditional Chinese medicine. Professor Wang Xiaoqin believes that the core pathogenesis of this disease in traditional Chinese medicine is deficiency of the fundamental aspect and excess of the incidental aspect, spleen, and kidney deficiency is the fundamental aspect, heat toxicity, water dampness, phlegm-turbidity, and blood stasis are the incidental aspect, blood stasis of the veins runs through the whole process of the disease. In the early stage, the treatment is mainly to replenish qi, nourish yin, and tonify kidney essence, commonly used Shenqi Dihuang Decoction modified. In the middle stage, on the basis of reinforcing the health and consolidating the fundamental, the combined symptoms were treated according to syndrome differentiation. If there was no obvious edema, Buzhong Yiqi Decoction was used. If edema was accompanied by a large amount of proteinuria, solid spleen decoction was often used. In the late stage, it is mainly treated with tonifying kidney and spleen, regulating yin and yang, removing dampness, and discharging turbidity. It is often treated with Shenyuan Granules for tonifying kidney and discharging turbidity combined with self-made tonifying qi and invigorating spleen and activating blood and discharging turbidity decoction. This article summarizes Professor Wang Xiaoqin’s unique experience in treating diabetic nephropathyby stages with addition and reduction of classical formulas.