北京中医药大学学报2025，Vol.48Issue(3)：386-391,6.DOI:10.3969/j.issn.1006-2157.2025.03.012
基于"糖毒"探讨糖尿病肾脏疾病"内热致癥"病机及其辨治思路
Exploring the pathogenesis of"internal heat leading to zheng"in diabetic kidney disease from the perspective of"glucose toxicity"and its differential diagnosis and treatment
摘要
Abstract
Diabetic kidney disease(DKD)is a common microvascular complication of diabetes."Internal heat leading to zheng"is the core pathogenesis of DKD,while"glucose toxicity"is transformed from subtle substances through"internal heat"and the cementation of various pathological products,which is pivotal to the transformation of diabetes to DKD."Glucose toxicity"is characterized by deep and widespread heat,caused by various pathological factors,and its sticky nature makes it difficult to resolve,which can cause severe damage to the kidney collaterals.In the early stage of"glucose toxicity",it is yang pathogen,which can be transformed into yin pathogen in the later stage with disease progression.In clinical practice,treatment should be based on disease staging,with attention on grasping the pathogenesis of"internal heat leading to zheng"and identifying the nature of"glucose toxicity".During the diabetic period,clearing heat is the primary method,often using modified Yueju Pill and Dachaihu Decoction.In the early stage of DKD,treatment primarily focuses on clearing and penetrating latent heat to treat DKD,aiming to prevent toxic heat from transitioning from qi to blood.The approach emphasizes clearing heat and re-penetrating,detoxification,and re-clearing,often using a self-made modified Qingre Xiaozheng Decoction.In the middle and late stages of DKD,the focus shifts to clearing heat,eliminating zheng,strengthening vital qi,and dispelling turbidity,with commonly used treatments including the self-made modified Xiezhuo Xiaozheng Formula,Jingui Shenqi Pill,and Zhenwu Decoction.关键词
糖尿病肾脏疾病/糖尿病/糖毒/内热/内热致癥Key words
diabetic kidney disease/diabetes mellitus/glucose toxicity/internal heat/internal heat leading to zheng分类
中医学引用本文复制引用
胡聿昕,曹博宁,王琳,高子衡,林茂炫,薛泽宇,刘伟敬,王耀献..基于"糖毒"探讨糖尿病肾脏疾病"内热致癥"病机及其辨治思路[J].北京中医药大学学报,2025,48(3):386-391,6.基金项目
国家自然科学基金区域创新发展联合基金重点支持项目(No.U22A203373) （No.U22A203373）
中医药传承与创新"百千万"人才工程(岐黄工程)岐黄学者项目(国中医药人教发[2018]12号) （岐黄工程）
国家中医药管理局高水平中医药重点学科建设项目北京中医药大学中医肾病学(No.zyyzdxk-2023260) （No.zyyzdxk-2023260）
北京市自然科学基金项目(No.7244487) National Natural Science Foundation of China(No.U22A203373) （No.7244487）
