Professor Yu Shijia Early Diabetic Nephropathy Experience Summary

Diabetic nephropathy (DN) is one of the severe microascular complications of diabetes mellitus(DM), that is the most common cause of end-stage renal disease. It is the major cause of losing working-ability death for diabetic patients. Sclerosis and exudation are the typical pathological feature of DN, which is due to the damaged glomerular capillary by microcirculatory disturbance, microaneurysm forming and glomerular capillary basement membrane thickening. DN belongs to "Xiao-ke, Shen-xiao, Xiaoshen, Xia-xiao, Edema" in TCM. It is the complication of Xiao-ke. Its pathogenesis is deficiency of Blood and Qi of Zang-Fu due to long disease (Xiao-ke), Right treatment at early-stage of DN could eliminate microalbuminuria (MA) to slow the progress of DN. Recently, make a great progress on etiology , pathogenesis and oriental and western medical therapy at early-stage of DN, but couldn't bring about a real cure. Professor YU, raise the pathogenesis of the early DN induced the deficiency of Qi and Yin or complicated with blood stasis, and Qi deficiency of spleen and kidney or complicated with turbid dampness. DN is pathologically based on root deficiency and branch excess; root deficiency presents with spleen-kidney insufficiency and branch excess with turbid dampness and blood stasis. Spleen and kidney are the location of DN. TCM typing is for Qi and Yin deficiency, Qi and Yin deficiency complicated with blood stasis, Qi deficiency of spleen and kidney and complicated with turbid dampness. He advocates supplementing qi and nourishing yin, Activating blood and dissolving stasis in treatment. He promotes TCM should be combined with Western medicine, and different treatment should be at different stage of disease. It is effective to treat DN, treatment based on syndrome differentiation on TCM theory and combined with controlling blood glucose, blood pressure, preventing kidney and regulating blood lipid for professor YU.