基于"清浊相干"理论论治糖尿病肾病蛋白尿OA

Diabetic kidney disease(DKD)is a primary microvascular complication of diabetes and a leading cause of end-stage kidney disease.Its progressive development seriously threatens patients'quality of life and survival outcomes.Massive proteinuria is the main clinical manifestation of DKD.Western medicine treatments rely on anti-inflammatory drugs,glucocorticoids,etc.,but they have significant side effects,highlighting the urgent need for safer and more effective intervention strategies.Based on the theory of"mutual interference of clear and turbid qi"mentioned in Ling Shu:Yin-Yang and Purity-Turbidity,the core pathogenesis of DKD proteinuria is proposed as the internal generation of turbid pathogens and the disordered reversal of clear and turbid.It is elaborated through three aspects:"lung activating turbid sources",which leads to the external invasion of pathogenic qi and the initial generation of turbid sources;"spleen brewing turbid evil",which results in internal retention of damp-evil and the circulation of greasy turbid factors;and"kidney deficiency causing turbid stagnation",which leads to turbidity-induced stasis damaging the collaterals and impairment of storage function.Correspondingly,the treatment principles are established as"disseminate the lung and regulate water to control turbidity","transport the spleen to transform and remove turbidity"and"benefit the kidney and protect the collaterals to eliminate turbidity".This highlights the advantages of traditional Chinese medicine in regulating clear and turbid qi and protecting kidney function,aiming to provide new ideas and methods for the integrated Chinese and Western diagnosis and treatment of DKD proteinuria.