基于肠-肾轴理论从脾肾辨治糖尿病肾脏病

Differentiation of diabetic renal disease from spleen and kidney based on gut-kidney axis theory

关键词:  糖尿病肾脏病  肠-肾轴  肠道微生态  中医药  院内制剂

Key words:  diabetic kidney disease  gut-kidney axis  intestinal microecology  traditional Chinese medicine  in-hospital preparation

摘要:

探索肠-肾轴理论内涵及其与糖尿病肾脏病（DKD）之间的关系，中医学角度从脾肾论治糖尿病肾脏病。结合中西医最新研究进展，剖析肠-肾轴理论，阐述其参与DKD发生发展的机制，并浅要论述中医药辨治原则与治疗策略。DKD的病机关键为脾肾亏虚、肠腑功能失调，中医药不仅能够补脾益肾，扶正祛邪，还可通过调节肠道菌群、修复肠道屏障、纠正肠道代谢异常等恢复肠腑功能，临床常取得显著疗效。肠-肾轴与DKD的发生发展密切相关，临证时脾肾同调以治其本，恢复肠腑功能作为主要目标，改善肠道微生态是预防及延缓DKD进展的关键，基于肠-肾轴理论从脾肾论治，为DKD的治疗提供了新的辨治思路与理论依据。

Abstract:

To explore the connotation of the gut-kidney axis theory and its relationship with diabetic kidney disease（DKD），this paper presents a traditional Chinese medicine perspective on the treatment of DKD from the perspective of spleen and kidney. Combining the latest research progress of both traditional Chinese medicine and Western medicine，this paper analyzes the gut-kidney axis theory and elucidates its mechanism of participation in the development of DKD. It also briefly discusses the traditional Chinese medicine differentiation and treatment principles and strategies. The pathological key of DKD is spleen and kidney deficiency and intestinal function disorder. Traditional Chinese medicine not only can supplement spleen and kidney，support the body and dispel pathogenic factors，but also can restore intestinal function by regulating intestinal microflora，repairing intestinal barrier and correcting abnormal intestinal metabolism. Clinical studies often achieve significant therapeutic effects. The gut-kidney axis is closely related to the development of DKD. In clinical practice，the spleen and kidney are regulated together to treat the root cause，with restoring intestinal function as the main goal. Improving intestinal microecology is the key to preventing and slowing the progression of DKD. Based on the gut-kidney axis theory，traditional Chinese medicine treatment of this disease provides a new perspective on diagnosis and treatment and theoretical basis.