从黏膜免疫角度论IgA肾病中医病因病机及治疗进展  

Advances in TCM Etiology,Pathogenesis and Treatment of IgA Nephropathy from Perspective of Mucosal Immunity

作　　者：曾勤 徐建龙[1] 梁莹[1] 余仁欢[1] ZENG Qin;XU Jianlong;LIANG Ying;YU Renhuan(Department of Nephrology,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School,China Academy of Chinese Medical Sciences,Beijing 100007,China)

机构地区：[1]中国中医科学院西苑医院肾病科,北京100091 [2]中国中医科学院研究生院,北京100007

出　　处：《医学综述》2022年第1期163-167,共5页Medical Recapitulate

基　　金：北京市科技计划课题(Z141107002514162);中国中医科学院西苑医院课题(2019XYMP--12)。

摘　　要：IgA肾病是全球范围内最常见的原发性肾小球疾病,其致病机制尚不完全明确,可能与黏膜免疫关系密切,主要表现在黏膜感染和黏膜免疫功能失调两个方面,目前西医尚无针对IgA肾病的特异性疗法。中医认为,IgA肾病的核心病机为正虚邪实。近年来,临床专家试图从黏膜免疫角度探析IgA肾病中医病因病机,阐述黏膜感染与邪实致病(主要为风邪、湿热)、黏膜免疫功能失调与正虚致病(主要为肺脾肾亏虚)的关联,并以此指导确立治疗法则。从咽论治、从脾胃论治,是经过临床检验的有确切疗效的治疗方法,但未来仍需大量基础和临床研究探索其起效机制。IgA nephropathy is the most common primary glomerular disease in the world,and its pathogenesis is not completely clear.It may be closely related to mucosal immunity,mainly manifested in mucosal infection and mucosal immune dysfunction.At present,there is no specific treatment for IgA nephropathy in western medicine.Traditional Chinese medicine(TCM)believes that the core pathogenesis of IgA nephropathy is vital qi deficiency and pathogenic factor excess.In recent years,the clinical experts have tried to explore the etiology and pathogenesis of IgA nephropathy in TCM from the perspective of mucosal immunity,expounding the correlation between mucosal infection and pathogenic factor excess(mainly wind evil,damp heat),mucosal immune dysfunction and body deficiency(mainly the deficiency of lung,spleen and kidney function),so as to guide the establishment of clinical treatment rules.Treatment from the pharynx and from spleen and stomach is a clinically tested method with definite curative effect,while a large number of basic and clinical studies are still needed to explore its action mechanism in the future.

关 键 词：IGA肾病 黏膜免疫 黏膜感染 黏膜免疫功能失调 正虚邪实 中医治疗 

分 类 号：R692[医药卫生—泌尿科学]