基于田炳照的指导运用参乌益肾方辨治慢性肾脏病体会  

Experience of Syndrome Differentiation and Treatment of Chronic Kidney Disease with Shenwu Yishen Prescription Under Guidance of TIAN Bingzhao

作　　者：朱俊 沈娴文[1] 顾珍凤 张瑞林[1] 田炳照(指导) ZHU Jun;SHEN Xianwen;GU Zhenfeng;ZHANG Ruilin;TIAN Bingzhao

机构地区：[1]泰州市第四人民医院肾内科,江苏泰州225300 [2]泰州市第三人民医院,江苏泰州225300

出　　处：《新中医》2022年第20期178-182,共5页New Chinese Medicine

基　　金：2019年度江苏省第五期“333工程”科研资助项目(BRA2019194);泰州市科技支撑计划(社会发展)项目指令性计划(TS201929)。

摘　　要：介绍在田炳照主任中医师的指导下运用参乌益肾方辨治慢性肾脏病的临床体会。田炳照强调,中医治疗慢性肾脏病,宜以《黄帝内经》的基础理论进行分析,探求病因病机;同时指出,脾主运化由“运”和“化”两种功能组成,运和化密切联系,又略有区别,诊断、治疗、用药亦需推敲;并反复告诫我们用中药一定要遵从中医整体观、辨证论治、治病求本的基本原则,不可只盯着“肌酐”“蛋白尿”等而用所谓的特效药。参乌益肾方本为肾脏病泰斗邹云翔教授治疗慢性肾炎肾功能衰竭证属气阴两虚之名方,药味平淡而能疗顽疾沉疴。在田炳照老师的指导下,探索参乌益肾方中各药的用法,认为慢性肾脏病当属脾肾气虚、肾阴不足之气阴两虚证,或夹瘀、痰等邪,运用参乌益肾方辨治慢性肾脏病能取得良好疗效。This paper introduces the clinical experience of syndrome differentiation and treatment of chronic kidney disease with Shenwu Yishen prescription under the guidance of Director TIAN Bingzhao.TIAN Bingzhao stressed that,in the treatment of chronic kidney disease with Chinese medicine,the analysis should be carried out based on the basic theory of Huangdi Neijing,so as to find out the etiology and pathogenesis;he also pointed out that transportation and transformation that are both governed by the spleen are closely related and slightly different,therefore,careful consideration is a must during diagnosis,treatment,and medication.TIAN repeatedly warned that the use of Chinese medicinals must follow the basic principles including the concept of holism,syndrome differentiation and treatment,and seeking the root when treating disease,and should not only keep eyes on“creatinine”and"proteinuria"and then turn to the so-called specific medicine.Shenwu Yishen prescription was originally used by Professor ZOU Yunxiang,a leading kidney disease expert,to treat chronic nephritis and renal failure;it is a famous prescription for the syndrome of qi-yin deficiency;with neutral and bland medicinal flavor,it can treat lingering diseases.Under the guidance of TIAN,this paper explored the usage of various medicinals in Shenwu Yishen prescription.The results showed that chronic kidney disease should belong to the syndrome of the spleen-kidney qi deficiency and the kidney yin deficiency,or mixed with blood stasis,phlegm,and other pathogens,and the application of Shenwu Yishen prescription in the treatment of chronic kidney disease can achieve a good curative effect.

关 键 词：慢性肾脏病 脾肾气虚 肾阴不足 参乌益肾方 田炳照 

分 类 号：R692.9[医药卫生—泌尿科学] R249[医药卫生—外科学]