| Research background:Diabetic nephropathy is a clinical disease,which belongs to the category of "thirst","urinary turbidity","kidney dissipation","spleen disease","edema","drowning poison",etc.in Chinese medicine."edema","guange","drowning poison" and other categories.Diabetic nephropathy is developed from diabetes mellitus,which is known as "thirst" in Chinese medicine.It is generally believed that thirst is mainly located in the lung,stomach and kidney,and the main pathogenesis is yin deficiency and dry heat.In clinical practice,it is found that: firstly,Yin deficiency and dry heat are rare in patients with diabetes or diabetic nephropathy,and treatment from Yin deficiency and dry heat is not effective;secondly,in modern medicine,the internal organs of diabetes are the pancreas,which is referred to as "spleen" in Chinese medicine,while the locus of thirst in Internal Medicine does not involve the "spleen".The disease is caused by the pancreas,which is called "spleen" in Chinese medicine.He inherited the academic thought of the theory of spleen and stomach gasification from the first national famous Chinese medicine doctor,Professor Zhang Xiaoping,and his treatment of diabetic nephropathy from the theory of spleen and stomach gasification is unique.The Yellow Emperor’s Classic of Internal Medicine also refers to diabetes as "spleen disease",therefore,it is necessary to dig into the classics and reconceptualize diabetic nephropathy from the perspective of spleen and stomach qi-chemistry.Objective:1.To discuss the theoretical origin of the treatment of diabetic nephropathy from the spleen and stomach qi-chemistry theory.2.To explore the relationship between spleen and stomach qi-chemistry and the pathogenesis of deficiency,dampness,stasis and toxicity in diabetic nephropathy.3.Summarize the instructor’s experience in the treatment of diabetic nephropathy using the theory of spleen-gastric qi chemistry.Methods:1.Through the analysis of the gasification,the physiological function and characteristics of the spleen and stomach,the relationship between the spleen and stomach,Li Dongyuan,the spleen,the spleen,and the theory of the treatment of diabetic kidney disease,the relationship between the deficiency,dampness,blood stasis,the spleen and the spleen and stomach,and the feasibility and advantages of the gasification of diabetic nephropathy.2.Through reading the main theoretical source of the academic thought of spleen and stomach gasification inherited by the tutor,Professor Zhang Xiaoping,the first national famous Chinese medicine doctor,and reading the relevant papers and writings of the tutor and his senior brothers and sisters,combined with the tutor’s clinical experience and cases,we summarize the tutor’s treatment rules and methods of treating diabetic nephropathy using the theory of spleen and stomach gasification,as well as his clinical experience.He also summarizes the treatment rules and methods of the instructor in treating diabetic nephropathy based on the theory of spleen-gastric qi,and his experience in treating diabetic nephropathy based on the six meridians,as well as his common prescriptions.3.Collect tutor from the spleen and stomach gasification theory of diabetic nephropathy cases,according to the western medicine diagnosis basis,diabetic nephropathy is divided into I～V,due to clinical phase I～II lack of typical symptoms and auxiliary examination,so the cases according to stage III,IV,V stage classification,analysis,summarizes different stages of diabetic nephropathy tutor cure syndrome and prescription rule.Study results:1.Diabetes mellitus is a pancreatic disease,so the treatment should be to regulate the spleen first;diabetic nephropathy is developed from diabetes mellitus,from the spleen to the kidney;through the four major aspects of dryness and dampness,nourishment and transformation,lifting and lowering,and access and diabetic nephropathy "deficiency" "dampness" "stasis" "toxicity".Therefore,regulating the spleen and stomach is the key to the prevention and treatment of diabetic nephropathy.2.The instructor treats diabetic nephropathy from the perspective of spleen and stomach qi-chemistry,emphasizing that "the disease lies in the spleen and pancreas,spleen regulation is the first priority,emphasis is placed on the spleen and stomach,the spleen and stomach are treated from the spleen,the prevention of diabetic nephropathy focuses on regulating the spleen and stomach,spleen and stomach qi-chemistry,and regulating blood sugar." He proposed the treatment principles of "regulating the qi mechanism,mediating the elevation and declination,nourishing and hydrating,drying and dampness,regulating both yin and yang,emphasizing the access and exit,and making good use of the six meridians",and at the same time,based on the theory of spleen and stomach qi chemistry and its play,he applied the six meridians to treat diabetic nephropathy,and proposed the corresponding classification of evidence and treatment,selection of prescriptions,key points of identification and clinical experience.3.Through statistical analysis of the collected cases of diabetic nephropathy treated by the tutor using the spleen and stomach qi theory,it was found that in the early stage(stage III)of diabetic nephropathy treated by the tutor,the main manifestation was mild abnormality of urinary microalbumin,and the distribution of evidence types was mainly Shaoyang and Jueyin,accounting for 63.5% of the total,and the selected prescriptions were mainly Xiao Chai Hu Tang,Si Wei San and Wu Mei Wan.The most frequently used drugs at this stage are Radix Codonopsis,Radix Astragali,Radix Cinnamomi and Radix Bupleurum;in the middle stage(IV),edema and microalbumin in urine are the main manifestations,mainly due to dampness and water-drinking,which are closely related to Shaoyang,Taiyin and Shaoyin,with Shaoyin heat and water-drinking accounting for26.9%,Yang deficiency and water flooding accounting for 21.2%,water-dampness congestion and spleen deficiency and dampness stagnation both accounting for 17.3%;Shaoyang dampness accounts for 11.5%,and the most commonly used formula is Pigling Tang,followed by Zhenwu Tang.The most commonly used formula is Pig Ling Tang,followed by Zhen Wu Tang,and the more frequently used drugs at this stage are Black Shun Tablet,Fu Ling,Ze Di,and Dan Shen.The late stage(V stage)is characterized by elevated toxic metabolites in the body and systemic symptoms,with dampness and blood stasis accounting for 40%,cold and blood deficiency accounting for 22.9%,turbidity offending the stomach accounting for17.1%,and elevation and declination accounting for 11.4%,indicating that patients at this stage are mostly in the stage of dampness and blood stasis,and poisonous evil is contained within the body.Fu Ling Wan accounted for 53.3% and 50.5%,respectively,and Dang Gui Si Wei Tang accounted for 41%,all of which are high frequency prescriptions used by the tutor;the frequency of using Fu Ling and Fa Xian Xia at this stage is very high,accounting for 97.1% and 99%,followed by Hossein and Citrus aurantium.4.The common drug pairs used by the instructor in the treatment of diabetic nephropathy using the theory of spleen and stomach qi are Huang Qi-Zhi Mu,Chai Hu-Citrus Aurantium,Gui Zhi-Poria,Aconite-Xi Cao,Ge Ge Gen-Chicken Shit Vine,Boneset-Cornus,and Turtle Board.-Cornus,turtle shell-turtle board,etc.Conclusion:1.Diabetes mellitus is a pancreatic disease,so the treatment should be to regulate the spleen first;diabetic nephropathy is developed from diabetes mellitus,from the spleen to the kidney.It is a supplement to the "Internal Medicine of Chinese Medicine" on the location and pathogenesis of "thirst".2.The "deficiency,dampness,stasis and toxicity" mechanisms of diabetic nephropathy are all related to spleen and stomach qi-chemistry,and the treatment of diabetic nephropathy based on the theory of spleen and stomach qi-chemistry has unique clinical efficacy and deserves further study.3.The instructor applied the six meridians to treat diabetic nephropathy based on the theory of spleen and stomach qi,which is a further expansion of the application of the theory of spleen and stomach qi and broadens the clinical thinking of diabetic nephropathy.4.In the clinical treatment of diabetic nephropathy,the tutor focuses on reconciliation and support of the righteousness in the early stage;elimination of evil in the middle stage;and elimination of evil and support of the righteousness in the late stage. |
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