2024 年第 5 期 第 0 卷

基于《黄帝内经》肾“苦欲补泻”理论探讨糖尿病肾脏疾病的遣方用药

Discussion on the prescription and medication of diabetic kidney disease based on the theory of "bitter to fill and reduce" of kidney in Huangdi Neijing

作者：潘芳1 张传龙2 庞博3

英文作者：Pan Fang1 Zhang Chuanlong2 Pang Bo3

单位：1北京市和平里医院中医内科，北京100013；2中国中医科学院广安门医院在读研究生，北京100053；3中国中医科学院广安门医院国际医疗部，北京100053

英文单位：1Department of Internal Medicine of Traditional Chinese Medicine Beijing Hepingli Hospital Beijing 100013 China; 2Graduate Student Guang′anmen Hospital China Academy of Traditional Chinese Medicine Beijing 100053 China; 3International Medical Services Guang′anmen Hospital China Academy of Traditional Chinese Medicine Beijing 100053 China

关键词：糖尿病肾脏疾病；《黄帝内经》；肾；苦欲补泻；中医辨治

英文关键词：Diabetickidneydisease;HuangdiNeijing;Kidney;Bittertofillandreduce;DifferentiationandtreatmentoftraditionalChinesemedicine

• 摘要：

• 糖尿病肾脏疾病是临床常见的糖尿病慢性并发症，已成为慢性肾脏病和终末期肾病的主要原因。中医认为其病位核心为肾，是肾体受损，肾用失司，肾元劳衰所导致的疾病。《黄帝内经》中载“肾苦燥，急食辛以润之”“肾欲坚，急食苦以坚之，用苦补之，咸泻之”。本文考究《黄帝内经》中肾“苦欲补泻”理论内涵，结合目前中医对于糖尿病肾脏疾病的主流治法，提出糖尿病肾脏疾病的中医辨治当以肾为关键，肾燥当予辛润之，肾虚当予苦补之，肾实当予咸泻之。以期为中西医结合治疗糖尿病肾脏疾病提供理论渊源，并为中医辨治糖尿病肾脏疾病提供新的思路与方法。

• Diabetic kidney disease is a common clinical chronic complication of diabetes mellitus, which has become the main cause of chronic kidney disease and end-stage renal disease. Traditional Chinese medicine believes that the core of the disease is the kidney, which is caused by the damage of the kidney body, the loss of kidney use, and the failure of the nephron. In Huangdi Neijing, it is recorded that "the kidney is bitter and dry, and the acute food is bitter to moisten it", "the kidney wants to be strong, and the acute food is bitter to strengthen it, and it is bitter to tonify it, and the salt reduces it".This article investigated the connotation of the theory of "bitter to fill and reduce" of kidney in Huangdi Neijing, and combined with the current mainstream treatment of diabetic kidney disease in traditional Chinese medicine, it is proposed that the differentiation and treatment of diabetic kidney disease in traditional Chinese medicine should focus on the kidney. The kidney dryness should be moistened by spicy, the kidney deficiency should be strengthened by bitterness, and the kidney is solid should be salty and reduced. In order to provide theoretical origin for the treatment of diabetic kidney disease with integrated traditional Chinese and western medicine, and provide new ideas and methods for the differentiation and treatment of diabetic kidney disease with traditional Chinese medicine.