对肾小球性蛋白尿中医病因病机的认识及治疗  

Understanding of the etiology and pathogenesis of renal glomerular proteinuria from the perspective of traditional Chinese medicine and the corresponding treatment

作　　者：郭兆安[1] GUO Zhao'an(Department of Nephrology,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Provincial Hospital of Traditional Chinese Medicine,Shandong,Ji'nan 250011,China)

机构地区：[1]山东中医药大学附属医院,山东省中医院肾病科,山东济南250011

出　　处：《中国医药科学》2020年第23期93-96,共4页China Medicine And Pharmacy

基　　金：山东省中医药科技发展计划项目(2017-055)。

摘　　要：蛋白尿是肾小球疾病的常见表现,无论其病理类型如何,中医对其有共同的认识。肾小球性蛋白尿的基本病机为本虚标实,本虚以肾失封藏、脾失统摄为主,标实以湿热蕴结、瘀血内阻为主;对应的中医临床辨证分型为肾气不足型、脾肾两虚型、湿热蕴结型、肾络瘀阻型;辨证治疗,分别治以补肾益气之参芪地黄汤、健脾补肾之培土固堤汤、清热化湿之加味四妙散、益气通络活血消积之益气通络饮。对同一个肾小球疾病进行不同的辨证分型治疗以及对不同的病理类型进行相同的治疗,其依据为中医"同病异治,异病同治"理论。Proteinuria is a common manifestation of renal glomerular diseases, and Chinese medicine has a common understanding of it regardless of its pathological types. The basic pathogenesis of renal glomerular proteinuria is deficiency of origin and excess of superficiality. Deficiency of origin is mainly caused by the dysfunction of kidney storage and spleen failing to control and manage, while excess of superficiality is mainly caused by damp-heat accumulation and internal blockade of blood stasis. The corresponding TCM clinical syndrome differentiation types are syndrome of kidney-qi deficiency, syndrome of spleen-kidney deficiency, syndrome of damp-heat accumulation and syndrome of kidney collaterals stasis, which are treated differently, with Shenqi Dihuang decoction for tonifying the kidney and replenishing qi, Peitu Gudi decoction for invigorating spleen and tonifying kidney, modified Simiao powder for clearing heat and eliminating dampness, and Yiqi Tongluo decoction for replenishing qi and dredging collaterals, Yiqi Tongluo decoction for promoting blood circulation and removing stagnation. Varied syndrome differentiation treatments for the same renal glomerular disease and the same treatment for different pathological syndromes are both based on the TCM theory of "varied treatments for the same disease and the same treatment for different diseases".

关 键 词：肾小球 蛋白尿 病因病机 辨证治疗 

分 类 号：R277.5[医药卫生—中医学]