从湿热论治岭南地区慢性肾脏病  

Differentiation and Treatment of Chronic Kidney Disease in Lingnan Area from the Aspect of Damp-heat Pathogenesis

作　　者：谢桂权[1] XIE Gui-Quan(Dept.of Nephrology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院肾内科,广东广州510405

出　　处：《广州中医药大学学报》2021年第1期188-191,共4页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：结合岭南地区地域与气候特点及慢性肾脏病的病情用药特点,认为岭南地区慢性肾脏病多以湿热为患,且患者多表现为湿热证。近年来的临床调查研究及分析提示岭南地区慢性肾脏病湿热证与感染并发症、炎症因子[血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素2(IL-2)、白细胞介素6(IL-6)等]、抗炎细胞因子(IL-4、IL-10、IL-12)等具有一定的相关性。结合临证实践,提出从三焦湿热立法,分上焦、中焦、下焦对岭南地区慢性肾脏病湿热证进行辨证用药,清利上、中、下焦湿热可分别选方藿香正气散、三仁汤、藿朴夏苓汤,甘露消毒丹、连朴饮、黄芩滑石汤,八正散、二妙散、三妙散、龙胆泻肝汤。治疗岭南地区慢性肾脏病湿热证的清利湿热经验方的主要组成为鱼腥草、板兰根、紫花地丁、苍术、薏苡仁、黄柏、石韦、玉米须。After analyzing the regional and climatic characteristics and the medication history in patients with chronic kidney disease in Lingnan area,it is considered that the pathogenesis of chronic kidney disease in Lingnan area is characterized by damp-heat,and the patients can be usually differentiated as the damp-heat syndrome.The recent clinical investigation and analysis showed that damp-heat type of chronic kidney disease in Lingnan area is correlated with the complications of the infection,the serum levels of proinflammatory factors such as Creactive protein(CRP),tumor necrosis factor alpha(TNF-α)and interleukin 2(IL-2), and anti-inflammatory factors of IL-4,IL-10 and IL-12. Based on the years of clinical experience,it is proposed that the damp-heat type of chronic kidney disease in Lingnan area can be treated from the aspect of triple-energizer damp-heat by clearing heat and draining dampness. For the treatment of chronic kidney disease in Lingnan area with upperenergizer damp-heat syndrome,Huoxiang Zhengqi Powder,Sanren Decoction,and Huo Pu Xia Ling Decoction can be selected;for the treatment of chronic kidney disease in Lingnan area with middle-energizer damp-heat syndrome,Ganlu Xiaodu Pills,Lian Pu Decoction,and Huangqin Huashi Decoction can be selected;for the treatment of chronic kidney disease in Lingnan area with lower-energizer damp-heat syndrome,Bazheng Powder,Ermiao Powder,Sanmiao Powder,and Longdan Xiegan Decoction can be selected. The experienced recipe for the treatment of damp-heat type of chronic kidney disease in Lingnan area by clearing heat and draining dampness is mainly composed of Herba Houttuyniae, Radix Isatidis, Herba Violae, Rhizoma Atractylodis, Semen Coicis,Cortex Phellodendri,Folium Pyrrosiae,and Stigmata Maydis.

关 键 词：岭南地区 慢性肾脏病 湿热证 三焦湿热 清热利湿 鱼腥草 板兰根 紫花地丁 苍术 

分 类 号：R692[医药卫生—泌尿科学]