| 范桢亮,樊琳萱,高源成,高祥福,马红珍,何灵芝,鲁科达,范军芬,项晓骏,夏虹,叶黎青.叶氏内科流派治疗糖尿病肾病经验浅析[J].浙江中西医结合杂志,2026,36(4): |
| 叶氏内科流派治疗糖尿病肾病经验浅析 |
| Analysis of Experience in Treating Diabetic Nephropathy with Ye's School of Internal Tradition Chinese Medicine |
| 投稿时间：2025-03-31 修订日期：2026-03-11 |
| DOI： |
| 中文关键词: 叶氏内科流派 糖尿病肾病 加味黄风汤 加减参芪地黄汤 加味温胆汤 消瘀泄浊饮 |
| 英文关键词:Ye"s School of Internal Tradition Chinese Medicine Diabetic Nephropathy Jiaweihuangfeng Decoction Jiajianshenqidihuang Decoction Jiaweiwendan Decoction Xiaoyuxiezhuo Decoction |
| 基金项目:浙江省中医药科技计划项目（2021ZB097，2024ZL049）；第七批全国老中医药专家学术经验继承工作；浙江省中医药流派工作室建设项目（叶氏内科）；李学铭全国名老中医药专家传承工作室建设项目（国中医药人教发〔2010〕59号）；高祥福名老中医专家传承工作室（GZS2020027）；马红珍名老中医专家传承工作室（GZS2017006） |
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| 中文摘要: |
| 目的:探索叶氏内科流派辨治糖尿病肾病的用药经验与学术思想。方法:选取2014年1月1日至2024年12月31日在浙江省中医院由叶氏内科流派医师(李学铭、高祥福、马红珍、何灵芝、鲁科达、范军芬、项晓骏等人)诊治的糖尿病肾病患者,筛选患者的临床方剂,运用自主研发的集合可视化分析系统3.0对中药处方信息进行关联分析,探索叶氏内科流派辨治糖尿病肾病的常用药物和高关联药物组合,分析其中所蕴含的临证经验和学术思想。结果:本研究共筛选出符合要求的中药方剂5166首,其中涉及中药474种。探索到“黄芪、防风、蝉蜕、僵蚕、青风藤”、“黄芪、党参、炒白术、生地、茯苓、山药、丹参”、“陈皮、姜半夏、黄连、大黄、茯苓、车前草”、“黄芪、川牛膝、桃仁、地龙、制大黄、车前草”等数个高关联药物组合,并反映出叶氏内科流派分期分型辨治糖尿病肾病的重要思想。结论:叶氏内科流派在辨治糖尿病肾病时强调分期分型论治,早期以补气益卫固表为主,兼以祛风除湿,利水消肿。重视消渴在传变过程中出现气阴亏虚,湿热中阻、浊毒壅结等病机变化,而在中晚期则强调肾虚瘀浊为核心病机,提倡以补气行血、消瘀通络、利湿泄浊为基本治则。 |
| 英文摘要: |
| Objective: To explore the experience and academic thought of Ye"s school of internal tradition Chinese medicine in differentiating the treatment of diabetic nephropathy. How: Patients with diabetic nephropathy diagnosed and treated by Ye"s school of internal tradition Chinese medicine physicians (Li Xueming, Gao Xiangfu, Ma Hongzhen, He Lingzhi, Lu Keda, Chen Hongbo, Fan Junfen, Xiang Xiaojun, etc.) in Zhejiang Hospital of Traditional Chinese Medicine from January 1, 2014 to December 31, 2024 were selected, and the clinical prescriptions of patients were screened. The self-developed collection visualization analysis system 3.0 was used to conduct correlation analysis of TCM prescription information, explore the common drugs and highly associated drug combinations used by Ye"s school of internal tradition Chinese medicine to distinguish diabetic nephropathy, and analyze the clinical experience and academic ideas contained in them. Results: A total of 5166 Chinese medicine prescriptions meeting the requirements were selected in this study, including 474 kinds of Chinese medicine. Explored several highly related drug combinations such as "Astragalus, Parsnip, cicadicola, Rigidopsis mori, Cyana", "Astragalus, Codonopsis, stir-fried white art, raw ground, Poria, Yam, Salviana", "Orange peel, ginger pinellia, Coptis, rhubarb, Poria, plantain", "Astragalus, Radix achyranthes, peach kernel, Ground dragon, Rhubarb, plantain", etc. It also reflects Ye"s school of internal tradition Chinese medicine important thought of differentiation and treatment of diabetic nephropathy by stages and types. Conclusion: Ye"s school of internal tradition Chinese medicine emphasizes the staging and classification in the differentiation and treatment of diabetic nephropathy. In the early stage, it mainly focuses on supplementing qi and strengthening exterior, and at the same time expels wind and dehumidifying water and detumescence. Attention should be paid to the pathogenesis changes of Qi Yin deficiency, dampness-heat obstruction, turbidity toxin obstruction, etc. In the middle and late stage, kidney deficiency and stasis should be emphasized as the core pathogenesis, and the basic therapeutic principles should be tonifying Qi to promote blood circulation, eliminating blood stasis and removing dampness-turbidity. |
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