世界中西医结合杂志2023年第18卷第1期WorldJournalofIntegratedTraditionalandWesternMedicine2023，Vol.18，No.1·理论探讨·DOI:10．13935/j．cnki．sjzx．230133基金项目:国家自然科学基金面上项目(82074242);天津市中医药重点领域科研项目(2018005)作者单位:1．北京中医药大学，北京100029;2．天津市中医药研究院，天津300120;3．北京中医药大学东方医院，北京100078通信作者:张勉之，Email:zhangmianzhi@vip．sina．com基于“心肾一体”辨证治疗糖尿病肾病李红典1，3李明轩1张勉之2，3【摘要】通过“心肾一体”理论阐述心肾之间的阴阳、精血、水火关系失当是发生糖尿病肾病(DiabeticNe-phropathy，DN)的内在原因。提出心肾之间阴阳失和贯穿DN始终，心肾精血失序是关键病机，心肾水火失济是关键病理变化。临床治疗时应把握调和阴阳、心肾同治，调养精血、化瘀通络，调节水火、交通心肾三个主要方面;同时兼顾清除血脉中膏脂废浊沉积，以求标本同治。总体达到恢复肾络血脉，心肾交通有序的目的。【关键词】糖尿病肾病;心肾一体;病因病机;心肾同治【中图分类号】Ｒ587．2【文献标识码】ATreatmentofDiabeticNephropathyBasedontheTheoryofHeartandKidneyInte-grationLIHong－dian1，3，LIMing－xuan1，ZHANGMian－zhi2，3(1．BeijingUniversityofChineseMedicine，Beijing100029;2．TianjinAcademyofTraditionalChineseMedicine，Tianjin300120;3．DongfangHospital，BeijingUniversityofChineseMedicine，Beijing100078)【Abstract】Weexplainedthattheimbalancebetweenyinandyang，betweenessenceandblood，andbetweenwaterandfirewastheinnercauseofdiabeticnephropathy(DN)basedonthetheoryofheartandkidneyintegration．Thedishar-monybetweenheartandkidneyisthekeypathogenicmechanismofDN．Specifically，thedisorderofessenceandbloodinheartandkidneyisthekeycause，andthatofwaterandfireinheartandkidneyisthekeypathologicalchange．TheclinicaltreatmentofDNshouldfocusonharmonizingyinandyang，treatingheartandkidneytogether，regulatingessenceandblood，resolvingstasisanddredgingcollaterals，regulatingwaterandfire，andlinkingheartandkidney．Atthesametime，thefatandwastedepositsinthebloodvesselsshouldberemoved，sothatboththesymptomsandtherootcausecanbetreated．Theoverallgoalistorestorethebloodvesselsoft...
