中医临床研究2025，Vol.17Issue(27)：51-56,6.DOI:10.3969/j.issn.1674-7860.2025.27.009
基于"主客交-玄府"理论探讨糖尿病肾病的因机证治
The etiology,pathogenesis,pattern differentiation,and treatment of diabetic nephropathy based on the theory of"host and guest interaction-Xuanfu"
摘要
Abstract
With the continuous improvement of the diagnosis and treatment level for diabetes,the mortality rate of patients caused by acute complications has been effectively controlled,while the incidence rate of diabetic nephropathy has shown a significant upward trend.Diabetic nephropathy,as a common and severe microvascular complication of diabetes,has now become an important cause of end-stage renal disease.Based on clinical symptoms such as edema,reduced urine volume,and foamy urine,ancient and modern medical experts have classified diabetic nephropathy into categories such as"diabetes nephropathy","edema",and"turbid urine".Once this disease occurs,it progresses year by year and is irreversible.Moreover,there is a lack of specific treatment methods.Currently,the combined treatment of traditional Chinese and Western medicine is the main approach.The theory of"host and guest interaction"(主客交)was founded by WU Youxing,a medical expert in the late Ming Dynasty.It inherits and further develops the pathogenesis theory in Huangdi Neijing(《黄帝内经》)to explain the pathological process of chronic diseases that are difficult to treat due to the deficiency of vital energy in the body,the internal invasion of external pathogenic factors,and the interweaving and entanglement of vital energy and pathogenic factors,which leads to the obstruction of Qi(气)movement.The theory of"Xuanfu"(sweat pore)was first seen in Huangdi Neijing,and gradually matured during the Jin and Yuan Dynasties.The ancient medical expert LIU Wansu emphasized that Xuanfu was the gateways of the circulation of Qi and body fluid,and continuous life activities.In this paper,from the perspective of"host and guest interaction-Xuanfu",the pathogenesis evolution process of diabetic nephropathy was divided into three stages as followed:Qi deficiency of kidney,lack of principal Qi,and abnormal opening and closing of Xuanfu,which is the root cause of the disease;the intermingling of phlegm turbidity and blood stasis with toxins leads to the long-term persistence of external pathogenic factors,causing Xuanfu to be unobstructed,which is the excessive superficiality of the disease;the interplay of deficiency and hyperactivity,and the entanglement of principal Qi and external pathogenic factors,which eventually lead to the blockage and imbalance of Xuanfu,resulting in a deterioration of the condition.This theory puts forward the core therapeutic principle of"distinguishing principal Qi and external pathogenic factors,and regulating Xuanfu",and respectively takes tonifying the kidney to regulate essence and consolidate Xuanfu,expelling pathogenic factors to detoxify and dredge Xuanfu,and separating principal Qi from external pathogenic factors to open Xuanfu as specific treatment methods,with the aim of providing new ideas for the prevention and treatment of diabetic nephropathy in traditional Chinese medicine.关键词
糖尿病肾病/玄府/主客交Key words
Diabetic nephropathy/Xuanfu/Host and guest interaction分类
医药卫生引用本文复制引用
郭晏资,胡维,王露瑶,谭诗..基于"主客交-玄府"理论探讨糖尿病肾病的因机证治[J].中医临床研究,2025,17(27):51-56,6.基金项目
湖南省自然科学基金项目(2024JJ9421) （2024JJ9421）
湖南中医药大学研究生创新课题(2024CX107). （2024CX107）
