国医大师吕仁和分期治疗隐匿性肾小球肾炎经验  

Experience of Traditional Chinese Medicine Master LYU Renhe in Treatment of Occult Glomerulonephritis by Stages

作　　者：王紫雯 李梓荣 杨俏丽 刘尚建[2] WANG Ziwen;LI Zirong;YANG Qiaoli;LIU Shangjian(Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院,北京100700

出　　处：《山东中医杂志》2022年第8期884-887,共4页Shandong Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(编号:2019YFC1710101);北京中医药大学首届名医培养计划人才项目。

摘　　要：吕仁和教授认为隐匿性肾小球肾炎初起多无明显症状,临床若仅依靠症状诊治易忽略病情进展,因此,应根据患者整体和局部临床表现,分三期论治本病。早期以祛邪为主,重在发散风热、祛风湿清热;中期扶正与祛邪兼顾,扶正以补益肺、肝、脾、肾为主,兼通活冲、任、督、带四脉,祛邪针对由气滞、血瘀、痰阻、食积、湿热壅滞等病机导致的病理产物,随证用药;晚期非大补不能救其虚,非通利不能解其闭,非软坚不能化其癥,故治以补益亏虚、通利二便、消癥化结、通利血脉。Professor LYU Renhe believes that occult glomerulonephritis has no obvious symptoms at the beginning,so if doctors in the clinic just relies on symptoms for diagnosis and treatment,it is easy to ignore the progress of the disease.Therefore,the disease should be divided into three stages according to the patients’global and local clinical manifestations,and the treatment varies with the stage.At the early stage,the treatments are based primarily on eliminating pathogen,especially on dispersing wind-heat,removing wind-dampness,and clearing heat.At the middle stage,the treatments combine reinforcing healthy qi with eliminating pathogen.Specifically,reinforcing healthy qi puts emphasis on tonifying the lung,the liver,the spleen and the kidney,supplemented by activating thoroughfare vessel,conception vessel,governor vessel and belt vessel,and eliminating pathogen is aimed at the pathological products caused by qi stagnation,blood stasis,phlegm obstruction,food accumulation,dampness-heat stagnation and other pathogenesis,choosing medicinals according to the syndrome.At the late stage,the deficiency can not be rescued without powerful tonification,the block can not be removed without promoting urination and bowel movement,and the mass can not be resolved without softening hardness,so the treatments include tonifying deficiency,promoting urination and bowel movement,dissipating mass,and freeing blood vessels.

关 键 词：隐匿性肾小球肾炎 分期论治 发散风热 消癥化结 吕仁和 

分 类 号：R249[医药卫生—中医临床基础] R277.5[医药卫生—中医学]