“提壶揭盖”法治疗IgA肾病的理论探讨  

Theoretical discussion on“lifting the pot and removing the lid”method in the treatment of IgA nephropathy

作　　者：汤文丽 占永立[1] 杨丽平[1] TANG Wenli;ZHAN Yongli;YANG Liping(Department of Nephrology,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院肾病科,北京100053 [2]北京中医药大学研究生院,北京100029

出　　处：《中国医药导报》2021年第18期136-139,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81102588、81473614)。

摘　　要：“提壶揭盖”是中医取类比象的治法之一,包括狭义上的扶正祛邪以启郁闭之肺和广义上的通行五脏壅滞以条畅周身气机两个方面涵义。IgA肾病是一种常见的原发性肾小球疾病,起病或急性加重期常具有外邪扰肺、肺卫不固的特点,慢性迁延期往往具有气机不畅的病机特点。因此,对于风邪为主的外邪证导致起病或急性加重,可考虑从肺着手,以玉屏风散、银翘散等固护肺卫、透邪外出。对于慢性迁延期临床疗效欠佳或易于复发者,以上焦肺气郁滞为主者,可少佐桔梗、杏仁等开宣肺气;对于中焦脾气之气机失常者,可加少量升麻、柴胡等以升举清阳,以求“提壶揭盖”。通过对“提壶揭盖”法治疗IgA肾病的理论基础进行探讨,为临床治疗IgA肾病提供新的思路。“Lifting the pot and removing the lid”is one of the analogistic treatment methods in Chinese medicine,mainly including two contents:in the narrow sense,invigorating the body and dispelling pathogenic factors to operate the stagnated lung qi;in a broad sense,it means that supporting the qi of five internal organs to regulate qi activity.IgA nephropathy is a common primary glomerular disease.The onset or acute exacerbation is often characterized by exogenous pathogenic factors invading lung and insecurity of the lung and the defensive qi,and chronic protracted stage is often characterized by dysfunction of qi movement.Therefore,for the reason that wind is the main exogenous pathogenic factor leading to the onset or acute exacerbation,it can be considered to treat IgA nephropathy by focusing on the lung,with Yupingfeng Power,Yinqiao Powder and other prescriptions to strengthen and protect lung,and to expel pathogenic factors.For patients with poor clinical efficacy of chronic delay or frequent relapse,the method of“lifting the pot and removing the lid”can be used.For patients whose lung qi are stagnated in the upper jiao,using Platycodonis Radix and bitter apricot seed can promote and regulate the lung qi.For those with disorder of ascending and descending of the spleen qi of the middle jiao,small dose of Cimicifugae Rhizoma and Bupleuri Radix can be added to raise yang.The exploration on the theoretic foundation of“lifting the pot and removing the lid”opens a new avenoue to clinical treatment of IgA nephropathy.

关 键 词：IGA肾病 提壶揭盖 宣发肺气 调畅气机 

分 类 号：R256.5[医药卫生—中医内科学]