李顺民教授辨治肾性血尿的临床经验介绍  

Professor Li Shunmin's Clinical Experience in the Treatment of Renal Hematuria

作　　者：凌舒艺 李雨彦[1] 祁爱蓉[1] LING Shu-yi;LI Yu-yan;QI Ai-rong(The Fourth Clinical Medicine School of Guangzhou University of Chinese Medicine,Shenzhen Guangdong 518033)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033

出　　处：《世界中西医结合杂志》2020年第9期1650-1653,1671,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目(20191278);深圳“医疗卫生三名工程”(SZSM201512040)。

摘　　要：肾性血尿指肾小球疾病引起的镜下或肉眼血尿,其病情缠绵,易反复发作,为现代医学治疗的一个难题,尚无特效药,而中医治疗对改善病情及预后具有一定优势。古籍对于血尿的论述多属湿热范畴,但李顺民教授经长期临床观察,发现单纯热结下焦所致肾性尿血并不多见,认为肾性血尿的病因病机可概括为"本虚标实",以脾肾两虚为本,且贯穿疾病始终,或兼夹湿热、夹痰夹瘀,因急性上呼吸道感染后出现的肉眼血尿则多属"外邪犯肺",可见风热、燥邪等。治疗上应以急则治其标,缓则治其本为原则,李教授常以健脾益肾法贯穿始终,兼解表祛风、清热祛湿、固涩止血、活血化瘀等综合辨证治疗。Renal hematuria refers to the microscopic or gross hematuria caused by glomerular disease Its condition is lingering and recurrent.It is a difficult problem for modern medical treatment.There is no specific medicine,and however,traditional Chinese medicine treatment has certain advantages in improving the condition and prognosis.Most of the discussions on hematuria in ancient books belong to the category of dampness and heat,but through long-term clinical observation,Professor Li Shunmin has found that renal hematuria caused by singularly heat in the lower burner is rare.He thinks the etiology and pathogenesis of renal hematuria can be summarized as“root vacuity and tip repletion”:spleen-kidney deficiency exists throughout the disease,with damp and heat,or phlegm and blood stasis,while the gross hematuria after acute upper respiratory tract infection is mostly external evil invading the lung,including wind heat,dryness and so on.On the treatment,it should be based on the principle that urgently cure its target,and then cure its original.Professor Li often runs through the method of invigorating the spleen and tonifying the kidney,and also uses comprehensive syndrome differentiation treatments such as dispelling wind,clearing heat and dampness,stagnating astringent and hemostasis,activating blood circulation and removing blood stasis.Professor Li's experience of treating renal hematuria was summarized for clinical reference.

关 键 词：肾性血尿 脾肾两虚 中医 李顺民 

分 类 号：R692[医药卫生—泌尿科学]