从湿论治肾病综合征水肿理论探析  

Theoretical Analysis of Treating Edema in Nephrotic Syndrome Based on Dampness Theory

作　　者：杨晨 王佳佳 毛心勇 柳诗意[2] 苏晓兰[2] YANG Chen;WANG Jiajia;MAO Xinyong;LIU Shiyi;SU Xiaolan(Miyun Hospital of Traditional Chinese Medicine,Beijing 101500,China;Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100102,China)

机构地区：[1]北京市密云中医医院,北京101500 [2]中国中医科学院望京医院,北京100102

出　　处：《山东中医药大学学报》2021年第5期608-610,615,共4页Journal of Shandong University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81904156)。

摘　　要：肾病综合征(NS)临床常见且难治,水肿是其突出症状,属中医学尿浊等范畴。水肿的形成以肾为本,以肺为标,以脾为枢,湿与NS发生发展密切相关,外湿或内湿夹杂风邪、郁热、痰浊、瘀血等,导致肺、脾、肾三脏功能失调,肺失宣降,脾失健运,肾失气化,水液潴留,泛溢肌肤,而为水肿。治疗上,或宣畅肺气以治其标,或健脾补脾以启脾之枢,或温肾阳、祛水邪而调其本。祛湿邪不忘扶正气,同时要考虑到NS水肿作为身心共病疾病,可酌情加入疏肝解郁、安神定志类的药物,以起到身心同治的效果。Nephrotic syndrome(NS)is clinically common and difficult to treat.Edema is its prominent symptom,which belongs to the category of turbid urine in Chinese medicine.The formation of edema is based on the kidneys,the lungs are the target,and the spleen is the center.Dampness is closely related to the occurrence and development of NS.External dampness or internal dampness is mixed with wind pathogen,stagnated heat,phlegm and blood stasis,etc.,resulting in the dysfunction of lungs,spleen,and kidneys.Lung qi failing in dispersion and descending,dysfunction of spleen in transportation,dysfunction of kidneys in qi transformation,water retention overflows the skin,causing edema.In terms of treatment,ventilate lung qi to treat the symptoms,or invigorate or tonify the spleen to reinforce the middle energizer,or warm the kidney yang and expel water pathogen to regulate the root.Both expelling damp pathogen and reinforcing healthy qi should be kept in mind,and at the same time,considering that NS edema is a comorbidity of the body and mind,medicinals for soothing the liver,relieving depression and calming the mind can be added as appropriate to achieve the effect of simultaneous treatment of the body and mind.

关 键 词：湿 肾病综合征 水肿 尿浊 发汗 利小便 

分 类 号：R277.5[医药卫生—中医学]