从“肾阴亏虚,郁火伏巢”论治小儿过敏性紫癜肾炎  

Treatment for children with Henoch-Schonlein purpura nephritis from"deficiency of kidney Yin,stagnated fire in the nest"

作　　者：郑珊[1] 罗磊 文仲渝 常克[2] ZHENG Shan;LUO Lei;WEN Zhongyu;CHANG Ke(Department of Pediatrics,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院儿科,重庆400021 [2]成都中医药大学附属医院儿科,成都610075

出　　处：《中国中西医结合儿科学》2022年第6期538-541,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：重庆市科委与卫生健康委联合中医课题(2022MSXM205);重庆市名老中医药专家学术经验传承工作项目。

摘　　要：基于邪伏少阴理论探讨过敏性紫癜肾炎的病因、病机、病程特点及临床症状。“肾阴亏虚”为内生伏邪的先决条件。外感六淫、进食辛发食物、触及过敏物质是本病的诱发因素。外邪由表入里,聚于咽喉,日久化热,形成伏火。肾阴亏虚引伏火循经内传,藏匿于少阴肾中。伏火耗伤津血,炼血为瘀。瘀火互结成为病巢,盘踞肾络。伏火外发,正邪相争,热伤血络,血外溢肌肤,下渗小便,则出现皮肤瘀斑或血尿;伏火潜藏,正邪不相争,则无血尿或皮肤瘀斑。邪气潜伏与反复发作过程是伏邪疾病的基本特征。治疗上根据急性期和缓解期分阶段论治。急性期采用清降伏火,活血化瘀的攻邪之法,缓解期采用滋阴养血,修复肾脉的扶正之法,灵活运用复脉汤、抵挡汤及六味地黄丸对过敏性紫癜肾炎进行全方位的治疗。可直捣病巢,破除伏邪,截断扭转肾炎缠绵难愈的病势。This paper discusses the etiology,pathogenesis,course characteristics and clinical symptoms of Henoch-Schonlein purpura nephritis based on the theory of’pathogen lodging in Shaoyin’.The deficiency of kidney yin is the primary condition of hidden pathogen storing in the body.The inducing factors were exposure to six excesses,diet irritation and contact with allergic substances.External evil is from the surface into the inside,gathering in the throat.It turns into heat after along period of time and becomes a latent fire.The latent fire consumes the fluid and blood and becomes stagnated.The stagnated fire is interconnected and becomes disease of the nest,and stays at kidney collaterals.Latent fire goes outside,and the conflict occurs between pathogenic qi and vital qi.The heat damages the blood collaterals,blood overflows to the skin,and blood seeps to urine,then skin ecchymosis or hematuria occurs.The latent fire is hidden and thepathogenic qi and vital qi are not in conflict,then there is no hematuria or skin ecchymosis.The latent and recurrent process of pathogenic qi is the basic feature of insidious pathogenic diseases.The treatment often depends on its stages,including acute stage and remission stage.In the acute stage,the treatment methods are clearing latent fire,activating blood circulation and dispelling blood stasis.In the remission stage,the treatment methods are nourishing Yin and blood and repairing kidney veins.Fumai decoction,Didang decoction and Liuwei Dihuang pill can be used flexibly in a comprehensive treatment for Henoch-Schonlein purpura nephritis.Eliminating the disease nest and removing the insidious pathogens can stop and reverse the persistent and refractory disease of nephritis.

关 键 词：过敏性紫癜肾炎 邪伏少阴 肾阴亏虚 伏邪学说 

分 类 号：R692.34[医药卫生—泌尿科学]