Treatment of diabetic nephropathy with Chinese medicine characteristics

Diabetic kidney disease (DKD), also known as diabetic nephropathy, is one of the common complications in the development of diabetes. About 20% to 40% of diabetic patients in my country have diabetic nephropathy, which has become the main cause of chronic kidney disease (CKD) and end-stage renal disease. Diabetic nephropathy is diagnosed based on elevated urinary albumin and/or decreased estimated glomerular filtration rate, while excluding other chronic kidney diseases. DKD is mainly manifested by varying degrees of proteinuria and progressive decline in renal function, which eventually leads to end-stage renal disease.

Modern medicine believes

The risk factors for diabetic nephropathy include unhealthy lifestyle habits, age, disease course, blood sugar, blood pressure, obesity, blood lipids, uric acid, environmental pollutants, etc.; the pathogenesis of DKD is often related to lipid metabolism disorders, chronic inflammatory response, activation of immune mechanisms, cell pyroptosis and autophagy, acceleration of oxidative stress, epigenetics, etc., and the specific pathogenesis is still unclear.

Currently, clinical treatment is mostly

Adjusting diet and other lifestyles, regulating blood sugar, blood pressure, blood lipids, regulating urine protein, improving microcirculation, and using renin-angiotensin system inhibitors (ACEI/ARB), SGLT2i, aldosterone receptor antagonists, etc., but they cannot effectively delay the progression of DKD to renal failure and have certain limitations. Proteinuria is a sensitive indicator of diabetic kidney damage and a risk factor for continued deterioration of renal function. It can predict the progression of clinical kidney disease and renal function. Therefore, early and active control of urine protein is very important for delaying the deterioration of renal function.

This disease belongs to the category of "edema", "consumption", "shutuo" and so on in traditional Chinese medicine. Ancient and modern doctors generally believe that the basic pathogenesis of this disease is deficiency of the root and excess of the side. The root deficiency is mainly deficiency of qi and yin or deficiency of spleen and kidney. If the disease is not cured for a long time, multiple organs will be affected. In the process of disease development, pathological products of excess such as stasis, phlegm, dampness, toxins and wind will gradually be produced, which will affect the outcome of the disease.

The Endocrinology Department of our hospital is characterized by the holistic concept of traditional Chinese medicine and the treatment based on syndrome differentiation. It prescribes and uses medicines, and cooperates with other traditional Chinese medicine therapies such as acupuncture and massage, Chinese medicine enema, and acupoint application. It can more effectively improve the patient's clinical symptoms on the basis of simple Western medicine treatment, effectively control blood sugar, improve urine protein excretion rate, etc., protect kidney function, and thus delay the development of DKD patients.

DKD patients should be given a high-quality, low-protein, vitamin-rich diet, and plant protein such as beans should be limited. Patients with edema and hypertension should limit their sodium intake.

According to the patient's condition, Chinese medicine and diet are given to balance yin and yang, regulate the internal organs, and strengthen the body and eliminate evil. For example, people with kidney yang deficiency should often eat leeks, dog meat, sheep bones, shrimps, cinnamon and other foods; people with kidney yin deficiency should eat wolfberry, mulberry, turtle meat, fungus, white fungus and other foods; people with spleen deficiency should eat white lentils, coix seeds, yam, lotus seeds, etc.; people with bladder dampness and heat should eat purslane, houttuynia, mung beans, red beans, etc. In addition, dietary prescriptions can also be selected according to the patient's condition. For example, for spleen and kidney deficiency, Huangqi Yam Congee (Huangqi, Yam) can be used; for edema, Coix Seed Congee (Coix Seed, glutinous rice) or Huangqi Winter Melon Soup (Huangqi, Winter Melon) can be used.

In the early stage of the disease, traditional exercise methods such as Tai Chi, Wu Qin Xi, Ba Duan Jin, He Xiang Zhuang, Qiang Qiang Gong, etc. can be used. Moderate exercise is not suitable for strenuous exercise. Patients with renal failure should mainly rest in bed, and the amount of activity should not be too large, and they should not be overworked. Qigong ± Nei Yang Gong and other static exercises can be used. The purpose is to balance the yin and yang of the human body, harmonize qi and blood, and unclog the meridians, which has a certain auxiliary effect on the recovery of the patient.