鲁玉梅 袁玲 呼延昕娜 南一

【摘 要】  糖尿病肾病是糖尿病的严重微血管并发症之一，早期症状隐匿，病程进展较快，并发症较多，严重危害人类的健康。对于临床上常见的糖尿病肾病，南一教授认为病机是本虚标实，以气阴两虚为病之本，兼有瘀毒为其标，治以补气养阴，祛瘀解毒通络，以此思路辨证论治，临床上取得明显效果。

【关键词】  糖尿病肾病;气阴两虚;瘀毒;辨证论治

【中图分类号】R249.2/.7   【文献标志码】A    【文章编号】1007-8517（2020）11-0078-03

Preliminary study on the trial of Professor Nan Yi in Treating Diabetic Kindey Disease

LU Yumei1 YUAN Ling2，3 HUYAN Xin na1 NAN Yi1，2△

1. Ningxia Medical University， Yinchuan 750004， China;

2. Ningxia Medical University Key Laboratory of Hui Ethnic Medicine Modernization Ministry of Education，Yinchuan 750004， China;

3. Pharmacy College of Ningxia Medical University， Yinchuan 750004， China

Abstract： Diabetic kindey disease is one of the serious microvascular complications of diabetes， which seriously endangers human health， with the insidious early symptoms and the course of disease progresses quickly. For the common clinical diabetic nephropathy， Professor Nanyi believes that the pathogenesis is the essence of deficiency， and the deficiency of qi and yin is the root cause of the disease， with both stasis and poisoning as the standard. Based on this thinking， we have achieved obvious results clinically.

Key words： Diabetic Kindey Disease; Deficiency of Qi and Yin; Stasis and Poison; Treatment Based on Syndrome Differentiation

糖尿病腎病是由糖尿病引起的慢性肾脏损害疾病，临床上以持续的高血糖、蛋白尿为典型特征，早期症状隐匿，不易发现，病程进展较快，晚期只能依靠透析和肾脏移植来维持生命。杨霓芝[1]教授认为，本病病位主要在肾，可涉及脾、肺、肝等;其基本病机为阴虚燥热，气阴两伤，后期主要多见阴损及阳，阴阳两虚，最终致脾肾阳衰，浊毒瘀阻。国医大师南征教授认为消渴日久，毒损肾络，邪伏膜原是本病的病机关键。本病属络病范畴，毒邪贯穿于本病的始终[2]。南一教授曾师从南征教授学习数年，致力于糖尿病慢性并发症的中医药防治研究多年，形成了一套独特的治疗思路，多以气阴两虚兼有瘀毒为辨证依据，临床上治疗糖尿病肾病效果明显，现将其辨证思路阐释如下。

1 病因

1.1 先天禀赋不足 中医认为肾为先天，脾为后天，先天乃为人之本，对身体来说至关重要。《灵枢·本脏》云：“肾脆则善病消瘅易伤”，认为消渴的病因源于肾，肾虚则容易患病。《灵枢·五变》曰：“五脏皆柔弱者，善病消瘅”，即认为禀赋不足、五脏柔弱是糖尿病发病的主要原因。……