Based on the principle of

Corresponding author: Wang Li, wl15840214382@qq.com

DOI: 10.12201/bmr.202605.00036

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  Abstract: This article centers on Ye Tianshis theory that when the upper and lower parts are damaged, the middle part should be treated, systematically explores the core role of glycotoxicity in the evolution of DKD(DKD), and constructs the corresponding diagnosis and treatment system. DKD often involves multiple systems and is characterized by a complex pathological state of upper damage to the heart and lungs and lower damage to the liver and kidneys. The root cause lies in the failure of the middle jiao to transport and transform, resulting in the generation of sugar toxins due to the lack of digestion of food and water. Glycotoxicity, as the initiating factor, progresses from superficial to profound as the disease progresses: during the accumulation stage, it blocks the middle jiao, leading to abnormal ascending and descending of qi movement; During the dissipation period, there is qi deficiency and blood stasis, with a mixture of deficiency and excess. During the period of deficiency and loss, the syndrome of cemented formation occurs, resulting in deficiency of both Yin and Yang. Based on this, the principle of treating the middle is established as the leading approach, and treatment is carried out in stages: during the accumulation period, when sugar toxins accumulate in the middle jiao, strengthening the spleen, eliminating turbidity, and using bitter and sour flavors to clear heat can curb the progression of the disease. During the dissipation period, it is necessary to tonify qi and nourish Yin, unblock meridians and dissolve sugar to repair damage. During the period of deficiency and weakness, it is necessary to eliminate turbidity and symptoms, support the bodys resistance and expel pathogenic factors. This strategy aims to block the source of glucotoxicity by restoring the spleen and stomachs transformation and transportation functions, solve the situation of the same disease in the upper and lower parts, and provide a diagnosis and treatment plan with traditional Chinese medicine characteristics for improving the clinical efficacy of DKD.

  Key words: DKD; When there is a loss between the upper and lower parts, treat the middle part; glucose toxicity

  Submit time: 9 May 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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