AL型肾淀粉样变性病的中西医诊疗进展  

The Progress in the Diagnosis and Treatment of TCM and Western Medicine of AL Type Renal Amyloidosis

作　　者：范桢亮 于珊珊[2] 尹日平 杨乔瑞 申意伟 贠捷 FAN Zhenliang;YU Shanshan;YIN Riping;YANG Qiorui;SHEN Yiwei;YUN Jie(The First Afiliated Hospital of Zhejiang Chinese Medical University/Zhejiang Prov incial Hospital of Chinese Medicine,Hangzhou 310006,China;Heilongjiang University of Chinese Medicine;The First Clinical Medical College,Heilongiang University of Chinese Medicine;Department of Nephrology,The First ffiliated Hospital of Heilongjiang University of Chinese Medicine)

机构地区：[1]浙江中医药大学附属第一医院/浙江省中医院,浙江杭州310006 [2]黑龙江中医药大学 [3]黑龙江中医药大学第一临床医学院 [4]黑龙江中医药大学附属第一医院肾病科

出　　处：《西部中医药》2020年第11期141-145,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81804088);黑龙江中医药大学研究生创新科研项目(2018yjscx007)。

摘　　要：从肾淀粉样变性病的发病差异与分型、AL型肾淀粉样变性病的临床表现、诊断与病理表现、治疗进展、肾淀粉样变性病的中医认识、病因病机、治则治法、辨证论治、其他治法等9方面入手综述AL型肾淀粉样变性病的中西医诊疗进展,指出近年随着肾活检的不断普及,AL型肾淀粉样变性病已经成为中老年继发性肾病综合征的主要病因之一,此类患者以水肿和乏力为主要临床表现,现有治疗方案主要以减少体内淀粉样物质积累为主;中医认为五脏不足,痰浊瘀血癥结经络脏腑是本病发病的关键;治疗强调标本兼治,补泻同施,活血化瘀,消癥散结;中西医结合可从多角度发挥治疗作用。The progress in the diagnosis and treatment of TCM and Western medicine of AL type renal amyloidosis were reviewed from the differences in morbidity and types of renal amyloidosis,clinical manifestations,diagnosis and pathological manifestations,therapeutic progress,TCM understanding,the cause and the pathogenesis,therapeutic principles and methods,syndrome differentiation and treatment,and other therapeutic methods,it was pointed out that AL type renal amyloidosis has become one of the main causes of secondary nephrotie syndrome in middle-aged and the elderly with the continuous popularization of renal biopsy in recent years,edema and fatigue were the main clinical manifestations in such patients,current therapeutic regimen was to reduce the accumulation of amyloid in the body mainly;the deficiency of five viscera,phlegm turbidity,blood stasis accumulated in the meridians and viscera is the key to the pathogenesis of the disease;the therapy emphasizes treating both the symptoms and root cause,reinforcing and reducing simultaneously,blood-activating and stasis-eliminating,eliminating stagnation and dispersing nodules;integrative medicine could develop the therapeutic effects from many aspects.

关 键 词：淀粉样变性病 轻链 五脏不足 活血化瘀 中西医结合 综述 

分 类 号：R692[医药卫生—泌尿科学]