摘要
简小兵认为糖尿病肾病发病与脾肾功能受损及气机升降失调密切相关。临床主要表现为水肿、腰膝酸软、倦怠乏力、小便频数甚或浑浊如膏脂,其中以水肿和尿浊最为难治。治疗以温补脾肾、滋阴温阳为大法,多采用金匮肾气丸、真武汤加减。用药多采用党参、白术、薏苡仁益气健脾化湿,杜仲、牛膝、枸杞子、女贞子调补肝肾,黄芪、当归、肉桂益气补血、调补脾肾以固本。在固护先后天之本之余,还多采用调理气机的方药,诸如鸡鸣散、升降散等,调节三焦气机,助水液运行,调畅气机以泄浊。选择典型医案两则进行简要分析,以供临床探讨。
JIAN Xiaobing believes that diabetic nephropathy is closely related to the dysfunction of the spleen and kidney and the disorder of qi movement.The main clinical manifestations are edema,weakness of waist and knees,fatigue,frequent urination or even turbidity like grease,among which edema and turbid urine are most difficult to be cured. The principle of clinical treatment is to warm and tonify the spleen and kidney,nourish yin and warm yang. Chinese medicinal herbs such as Dangshen(Changh Radix),Baizhu(Atractylodis Macrocephalae Rhizoma),Yiyiren(Coicis Semen) are used to invigorate the spleen qi and eliminate dampness,Duzhong(Eucommiae Cortex),Niuxi(Cyathular Radix),Gouqizi(Lych Fructus),Nyuzhenzi(Ligustri Lucidi Fructus) are used to nourish and replenish the liver and kidney,Huangqi(Astragali Radix),Danggui(Angelicae Sinensis Radix),Rougui(Cinnamomi Cortex) to tonify qi and nourish blood,invigorate the spleen and kidney to consolidate the foundation. In addition to consolidate the innate and acquired essence,many prescriptions for regulating qi movement,such as Jiming Powder,Shengjiang Powder are used to regulate qi movement in triple energizer,promote water metabolism,regulate qi movement for discharging turbidity. Two typical cases are selected to be analyzed for clinical discussion.
作者
程婷
简小兵
CHENG Ting;JIAN Xiaobing(Guangzhou University of Chinese Medicine,Guangzhou 510405,China)
出处
《山东中医药大学学报》
2018年第6期529-531,共3页
Journal of Shandong University of Traditional Chinese Medicine
关键词
糖尿病肾病
调理气机
医案
简小兵
diabetic nephropathy
regulating qi movement
medical case
JIAN Xiaobing
