益气养阴化瘀法治疗糖尿病肾病的用药策略

Abstract

目的：在KDOQI糖尿病指南和慢性肾脏病指导下，结合中医对糖尿病和糖尿病肾病的病因病机的认识，旨在揭示益气养阴化瘀法治疗DN的用药规律与机理。方法：基于KDOQI的糖尿病和慢性肾脏病指南，选取益气养阴化瘀法治疗DN的文献，寻找有关药物对糖尿病和慢性肾脏病的用药规律与机理。结果与结论：气阴两虚，瘀血阻肾是DN基本病机，益气养阴化瘀法是治疗DN的基本治法。益气养阴化瘀法治疗DN的用药规律为：在益气、养阴、活血化瘀类中草药中注重选取降糖、降压、调脂、抗凝类的中药；同时注重选取护肾、抗肾脏纤维化类中药保护肾功能。益气养阴化瘀法治疗DN的中药药理机制为：降糖、降压、调脂、抗凝、阻止肾脏纤维化。 Objective: KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease state that: controlling blood sugar, lowering blood pressure, regulating blood lipids, anticoagulation, preventing renal fibrosis, controlling proteinuria, controlling protein intake, reducing weight and so on are effective ways for prevention and treatment of diabetes and DN. This study aims to reveal herbal administration regularity and mechanism of tonifying qi, nourishing yin and dissolving stasis method (TQNYDSM) for treating DN. Method: Based on KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease, we select literatures of DN treated by TQNYDSM, looking for herbal administration regularity and mechanism of TQNYDSM for Treating DN. Results and Conclusion: Deficiency of both qi and yin, renal blood stasis is the key pathogenesis of DN, TQNYDSM is the DN basic treatment method. Herbal Administration Regularity of TQNYDSM for Treating DN: try to add traditional Chinese medicine with effects on lowering blood sugar, blood pressure, regulating lipid, anticoagulation, against renal fibrosis into the prescription to protect renal function. Herbal mechanism of TQNYDSM for treating DN: hypoglycemic, antihypertensive, lipid-lowering, anticoagulation, preventing renal fibrosis.