Professor Lü Renhe 's "Six Pairs Of Treatment" Of Diabetes Mellitus

DKD, also known as DN is the chronic kidney injury caused by diabetes, is one of the most important microvascular complications of diabetes. DN is characterized by massive proteinuria, clinical manifestations included microalbuminuria, proteinuria, reduce of renal function at the course of disease. Founded by epidemiological studies that about half of the hemodialysis patients was caused by DN. The early pathological changes of DN included the incrassation of glomerular and the increase of glomerular mesangium matrix, at the end-stage of DN it’s uncluded diffuse glomerular sclerosis and nodular glomerular sclerosis, the later, also called as K-W nodules is the specificity of the pathological changes of diabetic nephropathy. DN onset hidden and have poor prognosis, once appear clinical proteinuria or find out the incrassation of glomerular and mesangium matrix most of the disease gradually increase to ESRD.Therefore the earlier diagnosis has great significance in the prevention and treatment of DN. Traditional Chinese medicine was the accumulation of Chinese culture by thousands of years. Holistic view and the treatment based on syndrome differentiation was the thoughts characteristics of TCM. In recent years, scholars research and regulate the ancient literature of TCM. After this years of research of using TCM theory to treat DN they found many useful experience for this disease. Most of them thought that we have many advantage in treating of DN. Professor Renhe Lv born at 1934, after learning with the famous old Chinese medicine such as Jinmo Shi, Bowei Qin, Chenyu Zhu, etc. at the Beijing university of Chinese medicine he had work on diabetes and its complications, chronic kidney disease, endocrine disease and metabolic disease for 54 years. During this years he came up with many useful experience to treat diabetes and its complications and chronic kidney disease such as "The Two, Five, Eight Therapeutic Schedule", "Six Ways of Diagnosis and Treatment", "pathology hypothesis micro-zhengjia of diabetic nephropathy", etc. He attaches great importance to staging diagnosis and treatment in DN. Beyond those, he also had many experience need us to study.He has divided diabetes and its complications into three parts through the theory of traditional Chinese medicine as "Pidan" period, "Xiaoke" period and "Xiaodan" period. DN belongs to the "Xiaodan" period. There are both similarities and differences in the TCM etiopathogenisis, pathogenesis and therapeutic method between DN and DM. The pathogenesis of diabetes can be summarized as the deficiency caused by excess. "Pidan", known as the heat of spleen caused by overeating feiganhouwei food. The pathogenesis of it is overflowing of five-qi. With the development of the disease the syndrome of damp-heat and stasis-heat gradually causes Qi and Yin deficiency. He thinks the pathogenic characteristics of DN is the insufficiency of natural endowment, deficiency of both qi and yin and obstruction of superficial venulles type. Then with the progress of the disease yin deficiency affecting yang lead to the spleen kidney Yang deficiency. At the late diabetic nephropathy, the pathogenic characteristics turned ioto the deficiency of Qi and blood, Yin and Yang.Professor Lv thinks the prevention and therapy of diabetic nephropathy include diet control, exercise, stable mood, and the control of blood glucose, blood pressure, blood fat. Through the Chinese medicine treatment of diabetic nephropathy we can reduce the severity and signs, and delay the progress of diabetic nephropathy. Based on the "Six Ways of Diagnosis and Treatment" he divided the diabetic nephropathy into three stages to treat DN. The classification method based on tht syndrome differentiation and the result of physical and chemical inspection. The treatment of early diabetic nephropathy includes nourishing and warming liver and kidney, clearing heat and nourishing blood, promoting blood circulation to remove blood stasis. The frequently-used traditional Chinese medicine includes rhizoma cibotii, dipsacus asperoides, tu-chung, cyathula officinalis kuan, the root of red-rooted salvia, radix paeoniae rubrathe, tree peony bark. The treatment of the middle and late period of diabetic nephropathy includes inducing diuresis for removing edema, dissipating phlegm and resolving masses, downbearing the turbid to clear away toxic materials. The frequently-used traditional Chinese medicine includes polyporus umbellatus, poria cocos, lycopus lucidus, alisma plantago-aquatica, rhubarb, the root bark of white mulberry, rhizoma sparganic, curcuma zedoaria, prunella vulgaris, ramulus euonyrni, etc.