主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2016, Vol. 39 ›› Issue (1): 5-9.doi: 10.3969/j.issn.1006-2157.2016.01.001

• 理论研究 •    下一篇

张景岳真阴精气理论在糖尿病肾病治疗中的应用探讨*

柳红芳, 张向伟   

  1. 北京中医药大学东直门医院 北京 100700
  • 收稿日期:2015-08-09 出版日期:2016-01-30 发布日期:2016-01-30
  • 作者简介:柳红芳,女,博士,主任医师,博士生导师
  • 基金资助:
    *北京市科委重大计划项目(No.SCW 201305)

Application of ZHANG Jingyue’s theory of genuine yin and vital essence on the treatment of diabetic nephropathy*

LIU Hongfang, ZHANG Xiangwei   

  1. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700
  • Received:2015-08-09 Online:2016-01-30 Published:2016-01-30

摘要: 糖尿病肾病是糖尿病危害最大的微血管并发症,中医辨证治疗对于临床症状和生活质量的改善较为明显,但对于客观指标如尿蛋白和血肌酐的下降效果不理想。张景岳真阴精气理论的内涵:真阴居肾中命门,蓄藏五脏之精,兼水火之用,阴精之载体,阳精之根基。治病当求于本,本在真阴。阴精虚损之治,首重填补真阴,善用厚味熟地,补气助化阴精。结合临床分析,认为真阴亏虚、因虚致实是糖尿病肾病的核心病机。阐释验之临床有效的糖尿病肾病治疗的五大法则:糖尿病肾病的核心治则为填补真阴;糖尿病肾病的核心治法为“峻补”真阴;补气生精是填补真阴的重要途径;固涩敛精是填补真阴的增效方法;祛邪复精是填补真阴的辅助手段。

关键词: 张景岳, 真阴, 精气, 糖尿病肾病, 临床应用

Abstract: Diabetic nephropathy (DN) is the most critical microvascular complication in patients with diabetes mellitus. In China, therapeutic options also include application of Chinese herbal compounds guided by syndrome differentiation treatment. Chinese medical treatment can attenuate greatly symptoms and improve the life quality, by contrast, the effects of reducing the Objective indicators such as urine protein and serum creatinine are far from satisfactory. This article summarizes the theory of genuine yin and vital essence proposed by ZHANG Jingyue, a renowned TCM doctors in Ming Dynasty, as the following explanations. Firstly, genuine yin staying at the gates of vitality in kidneys, saves essence of five zang-organs. Secondly, genuine yin has both the functions of water and fire, as the carrier of yin essence and the foundation of yang essence. Thirdly, treatment of disease should be based on the root cause which locates in vital essence. Fourthly, the primary treatment of deficiency of yin essence is nourishing genuine yin by application of Radix Rehmanniae Praeparata (Shu Dihuang) to reinforce qi and produce yin essence. After the analysis of clinical trials, we think that the core pathogenesis of DN is deficiency of genuine yin leading to deficiency syndrome transforming to excess syndrome. And the five rules of Chinese medical treatment on DN are listed as: the primary therapeutic principle is nourishing genuine yin; the primary therapy is powerfully tonifying genuine yin through the way of reinforcing qi and producing genuine yin, through the way of controlling and astringing essence to strengthen effects, and through the way of eliminating pathogenic factors and recovering essence to aid to nourishing genuine yin.

Key words: ZHANG Jingyue, genuine yin, vital essence, diabetic nephropathy, clinical application

中图分类号: 

  • R259.872