Exploring the pathogenesis of "internal heat leading to zheng" in diabetic kidney disease from the perspective of "glucose toxicity" and its differential diagnosis and treatment
10.3969/j.issn.1006-2157.2025.03.012
- VernacularTitle:基于“糖毒”探讨糖尿病肾脏疾病“内热致癥”病机及其辨治思路
- Author:
Yuxin HU
1
,
2
;
Boning CAO
1
,
2
;
Lin WANG
1
,
3
;
Ziheng GAO
1
,
2
;
Maoxuan LIN
2
;
Zeyu XUE
2
;
Weijing LIU
1
,
3
;
Yaoxian WANG
1
,
3
,
4
Author Information
1. Dongzhimen Hospital, Beijing University of Chinese Medicine
2. Beijing University of Chinese Medicine
3. Renal Research Institution of Beijing University of Chinese Medicine
4. Henan University of Chinese Medicine
- Publication Type:Journal Article
- Keywords:
diabetic kidney disease;
diabetes mellitus;
glucose toxicity;
internal heat;
internal heat leading to zheng
- From:
Journal of Beijing University of Traditional Chinese Medicine
2025;48(3):386-391
- CountryChina
- Language:Chinese
-
Abstract:
Diabetic kidney disease (DKD) is a common microvascular complication of diabetes. "Internal heat leading to zheng" is the core pathogenesis of DKD, while "glucose toxicity" is transformed from subtle substances through "internal heat" and the cementation of various pathological products, which is pivotal to the transformation of diabetes to DKD. "Glucose toxicity" is characterized by deep and widespread heat, caused by various pathological factors, and its sticky nature makes it difficult to resolve, which can cause severe damage to the kidney collaterals. In the early stage of "glucose toxicity", it is yang pathogen, which can be transformed into yin pathogen in the later stage with disease progression. In clinical practice, treatment should be based on disease staging, with attention on grasping the pathogenesis of "internal heat leading to zheng" and identifying the nature of "glucose toxicity". During the diabetic period, clearing heat is the primary method, often using modified Yueju Pill and Dachaihu Decoction. In the early stage of DKD, treatment primarily focuses on clearing and penetrating latent heat to treat DKD, aiming to prevent toxic heat from transitioning from qi to blood. The approach emphasizes clearing heat and re-penetrating, detoxification, and re-clearing, often using a self-made modified Qingre Xiaozheng Decoction. In the middle and late stages of DKD, the focus shifts to clearing heat, eliminating zheng, strengthening vital qi, and dispelling turbidity, with commonly used treatments including the self-made modified Xiezhuo Xiaozheng Formula, Jingui Shenqi Pill, and Zhenwu Decoction.
- Full text:2025052116363211924Exploring the pathogenesis of _internal heat leading to zheng_ in diabetic kidney disease from the perspective of _glucose toxicity_ and its differential diagnosis and treatment.pdf
