目的:探究基于脑肾相济理论探讨从神论治糖尿病认知功能障碍(Diabetic cognition dysfunction, DCD)的可行性,为中医辨证治疗DCD提供新的思路。方法:通过对古今消渴病及呆病、痴呆相关文献资料的分析和归纳,根据脏腑功能及关系,分析脑...目的:探究基于脑肾相济理论探讨从神论治糖尿病认知功能障碍(Diabetic cognition dysfunction, DCD)的可行性,为中医辨证治疗DCD提供新的思路。方法:通过对古今消渴病及呆病、痴呆相关文献资料的分析和归纳,根据脏腑功能及关系,分析脑肾在本病中的地位,总结归纳出治疗本病的辨证和治疗要点。结果:DCD归属于中医学“消瘅”或“消渴”合并“健忘”、“痴呆”等范畴,临床主要表现为记忆力、注意力、判断力等领域下降,其病位主要在脑,与五脏密切相关,尤与肾最为关系密切。肾藏精,精生髓,髓通过脊髓充于脑,脑为髓海,因此其病机以“肾精亏虚,脑髓失充”为主,肾精亏虚为发病关键,其次兼夹气虚、痰邪、瘀血。“肾精亏虚”致使脑髓失充是糖尿病认知功能障碍的发病之本,气阴两虚为糖尿病出现各种并发症的关键段,而阴虚根源于肾精亏虚,在此“肾精虚损”基础上化生的“痰瘀”损伤脑络、蒙蔽脑窍发为认知障碍。结论:临床治疗应以“补肾填精”为治疗之本,辅之以益气活血、化痰祛瘀通窍。基于脑肾相济理论从肾论治DCD科学合理,值得临床推广。Objective: To explore the feasibility of treating diabetic cognitive dysfunction (DCD) from the spirit based on the theory of combining brain with kidney, so as to provide new ideas for treating DCD based on TCM syndrome differentiation. Methods: Through the analysis and induction of ancient and modern literature on diabetes, dementia and dementia, according to the function and relationship of viscera, the position of brain and kidney in this disease was analyzed, and the syndrome differentiation and treatment points of this disease were summarized. Results: DCD belongs to the category of “eliminating malnutrition” or “quenching thirst” combined with “forgetfulness” and “dementia” in traditional Chinese medicine. Its clinical manifestations are mainly the decline of memory, attention and judgment, and its location is mainly in the brain, which is closely related to the five internal organs, especially the kidney. Kidney stores essence, which produces marrow, and the marrow fills the brain through the spinal cord, and the brain is the marrow sea. Therefore, its pathogenesis is mainly “kidney essence deficiency, brain marrow deficiency”, and kidney essence deficiency is the key to the pathogenesis, followed by qi deficiency, phlegm evil and blood stasis. Deficiency of kidney essence leads to brain marrow deficiency, which is the origin of cognitive dysfunction of diabetes. Deficiency of both qi and yin is the key segment of various complications of diabetes, while deficiency of yin is rooted in deficiency of kidney essence. Phlegm and blood stasis on the basis of this deficiency of kidney essence damages brain collaterals and blinds brain. Conclusion: Clinical treatment should be based on “tonifying kidney and replenishing essence”, supplemented by invigorating qi and promoting blood circulation. Resolving phlegm, removing blood stasis and dredging orifices. Based on the theory of combining brain with kidney, it is scientific and reasonable to treat DCD from kidney, which is worthy of clinical promotion.展开更多
文摘目的:探究基于脑肾相济理论探讨从神论治糖尿病认知功能障碍(Diabetic cognition dysfunction, DCD)的可行性,为中医辨证治疗DCD提供新的思路。方法:通过对古今消渴病及呆病、痴呆相关文献资料的分析和归纳,根据脏腑功能及关系,分析脑肾在本病中的地位,总结归纳出治疗本病的辨证和治疗要点。结果:DCD归属于中医学“消瘅”或“消渴”合并“健忘”、“痴呆”等范畴,临床主要表现为记忆力、注意力、判断力等领域下降,其病位主要在脑,与五脏密切相关,尤与肾最为关系密切。肾藏精,精生髓,髓通过脊髓充于脑,脑为髓海,因此其病机以“肾精亏虚,脑髓失充”为主,肾精亏虚为发病关键,其次兼夹气虚、痰邪、瘀血。“肾精亏虚”致使脑髓失充是糖尿病认知功能障碍的发病之本,气阴两虚为糖尿病出现各种并发症的关键段,而阴虚根源于肾精亏虚,在此“肾精虚损”基础上化生的“痰瘀”损伤脑络、蒙蔽脑窍发为认知障碍。结论:临床治疗应以“补肾填精”为治疗之本,辅之以益气活血、化痰祛瘀通窍。基于脑肾相济理论从肾论治DCD科学合理,值得临床推广。Objective: To explore the feasibility of treating diabetic cognitive dysfunction (DCD) from the spirit based on the theory of combining brain with kidney, so as to provide new ideas for treating DCD based on TCM syndrome differentiation. Methods: Through the analysis and induction of ancient and modern literature on diabetes, dementia and dementia, according to the function and relationship of viscera, the position of brain and kidney in this disease was analyzed, and the syndrome differentiation and treatment points of this disease were summarized. Results: DCD belongs to the category of “eliminating malnutrition” or “quenching thirst” combined with “forgetfulness” and “dementia” in traditional Chinese medicine. Its clinical manifestations are mainly the decline of memory, attention and judgment, and its location is mainly in the brain, which is closely related to the five internal organs, especially the kidney. Kidney stores essence, which produces marrow, and the marrow fills the brain through the spinal cord, and the brain is the marrow sea. Therefore, its pathogenesis is mainly “kidney essence deficiency, brain marrow deficiency”, and kidney essence deficiency is the key to the pathogenesis, followed by qi deficiency, phlegm evil and blood stasis. Deficiency of kidney essence leads to brain marrow deficiency, which is the origin of cognitive dysfunction of diabetes. Deficiency of both qi and yin is the key segment of various complications of diabetes, while deficiency of yin is rooted in deficiency of kidney essence. Phlegm and blood stasis on the basis of this deficiency of kidney essence damages brain collaterals and blinds brain. Conclusion: Clinical treatment should be based on “tonifying kidney and replenishing essence”, supplemented by invigorating qi and promoting blood circulation. Resolving phlegm, removing blood stasis and dredging orifices. Based on the theory of combining brain with kidney, it is scientific and reasonable to treat DCD from kidney, which is worthy of clinical promotion.
