王镁教授辨治糖尿病肾病临床经验.pdf

辽宁中医药大学2010届硕士学位论文摘要王镁教授从事临床医疗工作二十余载,在糖尿病及其并发症的诊断治疗方面积累了丰富的临床经验。糖尿病肾病(diabetic nephropathy,DN)又称糖尿病性肾小球硬化症,是糖尿病最丰要的慢性微血箭并发症之一。吾师认为DN属中医的消渴并肾病,消渴病久,本虚标实、虚实夹杂,病位虽主要在肾,但与脾密切相关,脾肾虚损是DN发病和病机演变的关键环节,因久病入络,血瘀证常贯穿始终。临床上重视辨证与辨病相结合,根据其病机及病变特点,治法上以调补脾肾为主、兼以活血化瘀。在长期的医疗实践中不断总结和创新,研制出治疗糖尿病肾病的糖肾安煎剂,随证加减应用于各期糖尿病肾病,取得了较为满意的疗效。因此,在西医有效降糖、降压、调脂等治疗基础上, 加用中医辨证治疗对于改善糖尿病肾病患者临床症状、减少尿蛋白排泄量、延缓糖尿病。肾病进展,预防终末期肾病方面带来很大益处。关键词:糖尿病肾病;中医药治疗;临床经验王镁教授辨治糖尿病肾病临床经验 Abstract Professor Wang Mei isengaged inthe clinical work more than 20years,who accumulates rich clinical experience at diabetes and nephropathy(DN)called diabetic renal glomerulus sclerosis,is one ofthe most important chronic pl Wang thought DN is attributable to Xiaoke and Shenxiao in traditional the location of disease isinthe kidney,the spleen isrelated and kidney deficiency isthe key link which the DNmorbidity and the pathogenesis evolut the blood stasis passes through Wang emphasizes on syndrome differentiation and treatment determination,according to DN pathogenesis and the pathological change characteristic,governs supplement of the spleen andkidney,removing extravasted blood at the same time. Summarized and the innovation unceasingly in the long——term medical pract ce,Professor Wang develops Tang shen an decoct ion inthe treatment of DN,and obtaining satisfactory curative ,Tang shen an decoction brings the very big profit at improving patient clinical symptom,reducing urine protein excretion bination treatment of traditiongal Chinese and Western medicine,which effectively prevents end stage renal disease. Keyword:Diabetic nephropathy;Chinese medicine treatment;Clinical experience 辽宁中医药大学201 0届硕士学位论文—、上·—jL· 刚吾糖尿病肾病(DN)是指糖尿病所致的肾脏疾病,又称糖尿病性肾小球硬化症,是糖尿病(Diabetes Mellitus,DM)最严重和最常见的慢性并发症之一,系由糖尿病性微血管病变所致,并成为终末期肾病(End—Stage Renal Disease,ESRD)的重要原因, 亦是糖尿病患者致死的主要原因之一“1。DN病理上主要表现为肾小球系膜基质增多和肾小球毛细血符基底膜(Glomerular Capi lary Basemen