糖尿病從腎論治臨床應用

身體的五臟、六腑、肌肉、血管、神經、骨髓、內分泌、腦等組織與器官功能損傷變異，都可能誘發高血糖。第二型糖尿病核心的病理生理學缺陷，是胰島素分泌缺失和胰島素阻抗。糖尿病需區分三階段治療。第一階段，以清熱益陰為主；第二階段以補腎養陰、氣陰兩補、引火歸元為主；第三階段，以溫補脾腎、陰陽雙補為主。五臟之傷，窮必及腎，糖尿病在熱性期緩解後，必損腎之根基。中期表現，或腎陰不足、或陰虛火旺、火不歸元；後期多表現陰病損陽，或腎陰陽俱衰，治療需注意陰陽互根互用，精氣互生，舉凡舌象、脈象或其他表現有腎虛徵兆，即考慮從腎論治，臨床效果甚佳。中醫補腎法，能修復胰島細胞的萎縮退化，治癒或減少西藥治療，改善併發症，維持良好的生存質量。

關鍵字

糖尿病中醫治療；第二型糖尿病；糖尿病從腎論治

並列摘要

Increased blood glucose levels (hyperglycemia) can be induced by disruptions in the normal physiological function of the tissues and organs throughout the entire body including the five viscera, six bowels, sinews, marrow, brain, and vascular, nervous and endocrine systems. In Type 2 diabetes mellitus (DM2) the key pathophysiological deficits are insufficient insulin secretion and insulin resistance. Diabetes can be divided into three treatment stages as follows: Stage 1 involves clearing heat and boosting yin; Stage 2 involves supplementing the kidney and nourishing yin, dual supplementation of qi and yin, and returning fire to the origin; and Stage 3 involves warm supplementation of the spleen and kidney and dual supplementation of yin and yang. When damage to the five viscera occurs the end always affects the kidney. In the the initial heat pattern stage and its subsequent resolution, the kidney function will be damaged. In the intermediate stage, this presents as either kidney yin insufficiency, yin vacuity fire effulgence, or fire unable to return to the origin. And in the late stage, this presents as detriment to yin affects yang and dual debilitation of kidney yin and yang. During the treatment process you must be mindful of the mutual rooting and interrelationship of yin and yang, mutual engendering of essence and qi, tongue and pulse manifestations, and other signs of kidney vacuity. If these signs and symptoms present, then the clinical application of kidney as basis for determining treatment can be used to effectively treat this pathocondition. The traditional Chinese medicine (TCM) kidney-supplementation approach effectively repairs islet cell atrophy and degeneration. This makes it possible to reduce the dosage of Western medicine drugs, and in some cases completely cures the pathocondition allowing for complete discontinuation of medication, improves symptoms of sequelae, and enables the patient to maintain a high quality of life.