王自敏辨治糖皮质激素在肾脏疾病应用中的不良反应经验  

WANG Zimin’s experience in differentiation and treatment of adverse reactions of glucocorticoids in renal diseases

作　　者：陈茜楠 王自敏 邢海燕[2] CHEN Qiannan;WANG Zimin;XING Haiyan(Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第一附属医院,河南郑州450099

出　　处：《陕西中医》2022年第5期632-635,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河南省中医管理局国家中医临床研究基地科研专项(2018JDZX090);河南省中医药科学研究专项课题(2017ZY2057)。

摘　　要：糖皮质激素在肾脏疾病治疗中应用广泛,长期大量使用时,发挥治疗作用的同时会带来较多的不良反应。王自敏教授认为糖皮质激素多具“纯阳”之性,初始及长期使用时,阳热过旺,易伤肾阴,减量阶段,阴损及阳,阴阳两虚,停用阶段,正气亏虚,阳气未复。对于其不良反应的防治,王老主张以分期论治为主,结合患者临床表现不同,适当加减用药,归纳总结三大治疗要点,扶正固本,重在脾肾;阴阳失调,平补阴阳;痰瘀内生,化痰祛瘀,提出治疗以“脾肾为本,阴阳为纲,兼顾痰瘀”的学术观点,临床依照此法进行论治,往往能够有效减少不良反应发生率。Glucocorticoids are widely used in the treatment of kidney diseases.When they are widely used for a long time,they will bring more adverse reactions while playing a therapeutic role.Professor WANG Zimin believes that glucocorticoids mostly have the nature of“pure yang”.During initial and long-term use,excessive yang heat is easy to hurt kidney yin.In the reduction stage,yin and yang are damaged,yin and yang are deficient,and in the discontinuation stage,positive qi is deficient,and yang qi is not restored.For the prevention and treatment of adverse reactions,WANG Zimin advocated that treatment should be based on stages,adding or subtracting drugs appropriately according to the different clinical manifestations of patients,and summarized the three main treatment points,strengthening the foundation,focusing on the spleen and kidney.Imbalance of yin and yang,flat supplement yin and yang;phlegm stasis endogenous,phlegm removal stasis.It puts forward the academic viewpoint of“spleen and kidney as the basis,yin and yang as the main principle,taking into account phlegm and stasis”.Clinical treatment in accordance with this method can often effectively reduce the incidence of adverse reactions.

关 键 词：糖皮质激素 不良反应 肾脏疾病 辨证论治 脾肾为本 

分 类 号：R692[医药卫生—泌尿科学]