论糖尿病肾病“络脉-玄府”病机及辛味药的应用

基于中医络脉与玄府理论,阐述肾络、肾玄府的结构与功能,提出糖尿病肾病的中医“络脉-玄府”病机。认为络脉与玄府在功能上相互协调,病理上相互影响。肾络阻滞、肾玄府开阖失常为糖尿病肾病的病机。糖尿病肾病早期肾络郁滞,肾玄府郁闭不通,病性多偏于邪实;中后期肾络瘀阻,肾玄府痿闭,肾功能衰竭,病性偏于正虚。临床治疗时倡导选用辛味药以开玄通络,于辨证论治基础上酌加辛味的风药可祛邪增效,为临床治疗糖尿病肾病提供思路。

Discussion on Traditional Chinese Medicine Pathogenesis of Diabetic Nephropathy Based on Theory of Collaterals and Sweat Pores and Application of Pungent Herbs

Based on the theory of collaterals and sweat pores in the field of traditional Chinese medicine,we derived the structure and function of renal collaterals and renal sweat pores,and explored the traditional Chinese medicine pathogenesis of diabetic nephropathy from the aspect of renal collaterals and renal sweat pores.It is believed that the collaterals and the sweat pores cooperate at the level of function,and interact with each other at the level of pathology.The blockage of the renal collaterals and the opening-closing dysfunction of renal sweat pores contribute to the traditional Chinese medicine pathogenesis of diabetic nephropathy.In the early stage,diabetic nephropathy is characterized by pathogenic-qi excess for the blockage of the renal collaterals and the obstruction of the renal sweat pores.In the advanced stage,diabetic nephropathy is characterized by healthy-qi deficiency for blood stasis blocking renal collateral and flaccid obstruction of the renal sweat pores.During the treatment,the pungent herbs for dispelling wind can be adopted for unblocking the sweat pores and dredging the collaterals based on the syndrome differentiation and treatment,so as to promote the dispelling of the pathogens and the enhancement of therapeutic effect.The discussion will provide thoughts for the clinical treatment of diabetic nephropathy.