刘红梅 李云楚 汪燕燕 倪青

摘要 糖尿病肾病是终末期肾病主要原因。倪青教授根据病证结合理论，总结多年临床经验，提出糖尿病肾病病证结合分期分步骤治疗。通过辨主证、辨兼证、辨指标，并结合疾病分期，确定主方、加减用药，包括单味药、对药、角药。形成病证结合诊疗模式。倪青教授病证结合分期分步骤治疗糖尿病肾病在临床取得良好疗效。该诊疗模式调理清晰、考虑全面，对于中医临证经验较少的年轻医生有极好的指导作用。

关键词 糖尿病肾病;病证结合;分期分步骤;辨证;辨指标;中医药疗法;名中医经验;倪青

Professor NI Qing′s Experience in Treating Diabetic Kidney Disease by Combining

Disease with Syndrome，by Stages and Steps

LIU Hongmei1，LI Yunchu2，WANG Yanyan3，NI Qing2

（1 Tangshan Hospital of Traditional Chinese Medicine，Tangshan 063000，China; 2 Guang′anmen Hospital，China Academy of

Chinese Medical Sciences，Beijing 100053，China; 3 Yinchuan Hospital of Traditional Chinese Medicine，Yinchuan 750001，China）

Abstract Diabetes Kidney Disease（DKD）is the main cause of end-stage renal disease.According to the theory of combination of disease and syndrome，Professor NI Qing summarized clinical experience and proposed the treatment of DKD by combining disease with syndrome，by stages and steps.By differentiating the main syndrome，the subordinate syndrome，the indexes according to the stages of disease，the main prescription can be determined，with flexible increase or decrease of medicine，including single drug，drug pairs and drug trios.This formed a diagnosis-treat model of disease and syndrome combination.Professor NI Qing has achieved good clinical effect in treating DKD by combining disease with syndrome，by stages and steps.This diagnosis-treat model is coherent and comprehensive in consideration，which can be an excellent guidance for young physicians who have little clinical experience in traditional Chinese medicine.

Keywords Diabetic Kidney Disease; Combination of syndrome and disease; By stages and steps; Syndrome differentiation; Analysis indexes; Traditional Chinese medicine therapy; Experience of prestigious Traditional Chinese medicine doctor; NI Qing

中圖分类号：R249文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.05.007

糖尿病肾病（Diabetic Kidney Disease，DKD）又称糖尿病肾小球硬化症，其病变特点包括肾小球血管受损、肾小球硬化及肾小球形成结节性病变。在糖尿病患者中，约25%患者会出现肾脏并发症，随着糖尿病患者人数的增多，DKD成为发达国家终末期肾脏疾病的最常见病因[1-2]。目前，西医治疗以纠正糖代谢紊乱，控制血压、血脂等肾脏血管危险因素为主，暂无其他特效疗法。倪青教授采用病证结合分期分步骤治疗DKD取得良好疗效。中医病证结合理论起源于《黄帝内经》，壮大于汉代《金匮要略》，《金匮》中每个病种都是病证结合的范例。在现代，西医病种不断增多，常无对应中医病证（名）。倪青教授提出DKD可从西医症状学、中医证候学角度，结合特异理化检测指标进行辨证，“病-症（证）-指标”三者合参辨证，病证结合进行诊断、辨证，结合疾病分期进行治疗，形成病证结合分期分步骤诊疗模式。……