李学铭治疗IgA肾病经验介绍  

Experience Introduction of LI Xueming in Treating IgA Nephropathy

作　　者：李星凌[1] 叶黎青[2] 马红珍[2] LI Xinglin;YE Liqing;MA Hongzhen

机构地区：[1]浙江中医药大学附属第三医院,浙江杭州310005 [2]浙江中医药大学附属第一医院,浙江杭州310003

出　　处：《新中医》2022年第20期187-191,共5页New Chinese Medicine

基　　金：浙江省中医药科技计划项目(2018ZA058);全国名老中医药专家传承工作室建设项目(国中医药人教发[2010]59号);浙江省中医药科技计划项目(2021ZB097)。

摘　　要：介绍李学铭教授治疗IgA肾病的临床经验。李学铭教授尤其重视《黄帝内经》的理论在IgA肾病诊治过程中的应用。认为IgA肾病与肺、脾、肾三脏关系密切,采用衷中参西之法指导IgA肾病的诊治。将IgA肾病分为五个主要证型,分别为风邪犯肺、肺胃伏热、肺脾气虚、脾肾阳虚、肝肾阴虚,有五种主要的治疗方法,分别为宣肺清热、清热宁血、平补肺脾、温补脾肾、滋补肝肾。此外,临床若出现除尿常规检查异常以外不具有明显症状时,在辨证论治的同时,宜重视以辨病论治为补充,通过理化检查和临床症状综合分析病因病机,病证相合。针对已用激素治疗者,重视辨清其病机本质,以中药增效减毒。This paper introduces the clinical experience of Prof.LI Xueming in treating IgA nephropathy.Prof.LI attaches great importance to the application of the theory in Huangdi Neijing during the treatment of IgA nephropathy.He believes that IgA nephropathy is closely related to the lung,spleen and kidney and adopts the method of combining Chinese and western medicine with the main focus on the former and the help from the latter to guide the diagnosis and treatment IgA nephropathy.He classifies IgA nephropathy into five types according to five main syndrome types,namely wind pathogen invading the lung,latent heat in the lung and stomach,lung-spleen qi deficiency,spleen-kidney yang deficiency and liver-kidney yin deficiency.And there are five main treatment methods which are diffusing the lung and clearing heat,clearing heat and pacifying blood,supplementing the lung and spleen,warming and supplementing the spleen and kidney and enriching and supplementing the liver and kidney.In addition,he also thinks that if there are no obvious symptoms except abnormal results of urine routine examination during treatment,we should pay attention to the disease identification as a supplement based on the syndrome differentiation,and comprehensively analyze the etiology and pathogenesis through physical and chemical examination and clinical symptoms.As for the patients who have been treated with hormones,we should pay attention to identifying the essence of its pathogenesis and apply Chinese medicine to enhance the efficacy and reduce the toxin.

关 键 词：IGA肾病 风邪犯肺 肺胃伏热 肺脾气虚 脾肾阳虚 肝肾阴虚 病证相合 李学铭 

分 类 号：R692.31[医药卫生—泌尿科学] R249[医药卫生—外科学]