基于“相火论”探讨温阳药在难治性肾病综合征中的应用  

Discussion on the Application of warm-Yang Drugs in Refractory Nephrotic Syndrome based on "Phase Fire Theory"

作　　者：常玉洁 苏珊珊[2] 潘月丽[2] CHANG Yujie;SU Shanshan;PAN Yueli(Shandong University of Traditional Chinese Medicine,Shandong Jinan 250000,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Jinan 250000,China)

机构地区：[1]山东中医药大学,山东济南250000 [2]山东中医药大学附属医院,山东济南250000

出　　处：《中医药临床杂志》2022年第6期1028-1032,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2019-0181)。

摘　　要：在长期和大剂量使用糖皮质激素治疗难治性肾病综合征过程中,下丘脑-垂体-肾上腺轴进行负反馈调节,抑制皮质醇功能。糖皮质激素与相火在生理功能上具有一致性。中医温阳药可以温阳壮相火,拮抗外源性糖皮质激素对下丘脑-垂体-肾上腺轴的抑制作用,提高皮质醇水平。基于“相火论”探讨在难治性肾病综合征诊疗过程中分阶段应用温阳药,大量激素阶段少佐温阳药以防相火受抑,减量维持阶段主以温阳药以壮相火。During the long-term and high-dose treatment of refractory nephrotic syndrome with glucocorticoids,the hypothalamic-pituitary-adrenal axis performs negative feedback regulation and inhibits cortisol function.Glucocorticoids and phase fire have the same physiological function.TCM warm yang medicine can warm yang and invigorate fire,antagonize the inhibitory effect of exogenous glucocorticoid on the hypothalamic-pituitary-adrenal axis,and increase the level of cortisol.Based on the “phase fire theory” to discuss the application of warming yang medicines in stages in the diagnosis and treatment of refractory nephrotic syndrome,in a large number of hormone stages,the warming medicines should be avoided to prevent the relative fires from being suppressed,and the main warming yang medicines are used in the maintenance stage to strengthen the phase fire.

关 键 词：相火论 温阳药 难治性肾病综合征 糖皮质激素 皮质醇 

分 类 号：R272.6[医药卫生—中医儿科学]