中医药研究论丛

221.15 糖尿病肾病变之中医治疗病例报告
TJ TCM.22(1) : 159-170, 2019
糖尿病肾病变之中医治疗病例报告
A Case Report of Traditional Chinese Medicine Treatment for Diabetic Nephropathy
黄晓怡 林郁甯*
花莲慈济医院中医部,花莲,台湾
【摘要】
慢性肾脏病在台湾是一项高发生率、高盛行率且高医疗花费之重要疾病。中医看待慢性肾脏病以症状表现为基准,自古就有中医药治疗肾病的诸多纪录与经验,对於运用在治疗现代人的慢性肾脏病上会有许多帮助。本病案患者为一60 岁男性,有高血压、糖尿病、高血脂病史,於民国98 年发现泡沫尿於肾脏科就诊,经切片检查为膜性肾病变及糖尿病肾病变,病情反覆遂於民国102/04/22 寻求中医治疗。推测原发性膜性肾病变导致患者肾功能变差,经由症状推导後有肾阴阳亏虚、肝阳上亢、血瘀热郁等证型。治则以补肾益气利水、养阴化瘀清热为主,随证加减。中药治疗後至今,肾功能改善、蛋白尿改善、水肿改善、腰酸改善,持续服药维持疗效。希望本病案可以作为临床中西医师做治疗慢性肾脏病的叁考。
【关键词】慢性肾脏病、膜性肾病变、糖尿病肾病变、中医药
Hsiao-Yi Huang1 Lin Yu-Ning1*
1Department of Chinese Medicine, Buddhist Hualien Tzu Chi Hospital, Hualien, Taiwan
【Summary】
Chronic kidney disease is an significant disease in Taiwan with high incidence, high prevalence and high medical expenses. Chinese medicine treats chronic kidney disease on the basis of symptoms. Since ancient times, there have been many records and experiences of traditional Chinese medicine for treating kidney disease, which can help a lot in the treatment of chronic kidney disease in modern time. The patient was a 60-year-old man with history of hypertension, diabetes, and hyperlipidemia. He visited in our hospital in the Department of Nephrology in 2009. The biopsy was taken and the results showed membranous nephropathy and diabetic nephropathy. Because his condition did not obviously improve, he turned to Chinese medicine Department for help in 2013/04/22. It is speculated that primary membranous nephropathy leads to poor renal function in patients. After the treatment of traditional Chinese medicine, renal function, proteinuria, edema and backache has improved. This case can be used as a reference for the treatment of chronic kidney disease by clinical Chinese and Western doctors.
Keywordschronic kidney disease, membranous nephropathy, diabetic nephropathy, traditional Chinese medicine