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陈伯华, 范军.国医大师张大宁教授基于“阴阳互根与转化”理论治疗糖尿病肾病的经验[J].湖南中医药大学学报英文版,2026,46(2):217-221.[Click to copy
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| 国医大师张大宁教授基于“阴阳互根与转化”理论治疗糖尿病肾病的经验 |
| 陈伯华,范军 |
| (天津中医药大学研究生院, 天津 301617;天津市中医药研究院附属医院肾病科, 天津 300120) |
| 摘要: |
| 糖尿病肾病（DKD）是糖尿病最主要的微血管并发症之一。国医大师张大宁教授基于《黄帝内经》中“阴阳互根与转化”理论指出，阴阳枢机失序为DKD发病的根本病机，其动态演变贯穿疾病始终：早期阴阳互根失守，阴虚络燥、精微下泄；中期阴阳转化滞涩，痰瘀胶结而肾络痹阻；晚期阴阳离决，浊毒壅塞三焦而脏腑俱损。治疗上紧扣此病机演变，分期论治，以调和阴阳枢机、修复肾络损伤为总则：早期以固本守络为要，中期重在通络化瘀，晚期主张和济阴阳。附验案一则，以期为中医药治疗DKD提供理论参考与临证借鉴。 |
| 关键词: 糖尿病肾病 糖尿病 阴阳互根 阴阳转化 枢机失序 |
| DOI：10.3969/j.issn.1674-070X.2026.02.001 |
| Received:August 11, 2025 |
| 基金项目:国家中医药管理局全国名老中医药专家传承工作室建设项目;天津市卫生健康委员会中医中西医结合科研课题(2023089);河北省中医药管理局科研计划项目(T2026037)。 |
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| Experience of Professor ZHANG Daning, a National TCM Master, in treating diabetic kidney disease based on the theory of “interdependence and transformation of yin and yang” |
| CHEN Bohua, FAN Jun |
| (Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300120, China) |
| Abstract: |
| Diabetic kidney disease (DKD) is one of the most critical microvascular complications of diabetes mellitus (DM). Based on the theory of "interdependence and transformation of yin and yang" recorded in Huang Di Nei Jing (Huangdi's Classic of Medicine), Professor ZHANG Daning, a National TCM Master, points out that the disorder of yin-yang pivotal dynamic constitutes the fundamental pathogenesis of DKD, and its evolution runs through the entire course of the disease. In the early stage, the interdependence of yin and yang is compromised, manifesting as yin deficiency with collateral dryness, and leakage of essence; in the middle stage, the transformation between yin and yang is blocked, leading to intermingled phlegm and blood stasis as well as obstruction of kidney collaterals; in the late stage, yin and yang become dissociated, resulting in accumulation of turbid toxins in the sanjiao and damage to all zang-fu organs. In terms of treatment, the therapeutic regimen is formulated in accordance with the progression of this pathogenesis and implemented in a stage-specific manner, with the general principles of regulating yin-yang pivotal dynamic and repairing the kidney collateral damage:the early stage focuses on "consolidating the root and protecting the collaterals," the middle stage emphasizes "unblocking collaterals and resolving stasis," and the late stage advocates for "harmonizing and restoring yin and yang." A verified medical record is provided, aiming to offer theoretical insights and clinical guidance for TCM in treating DKD. |
| Key words: diabetic nephropathy diabetes mellitus yin-yang interdependence yin-yang transformation disorder of pivotal dynamic |
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