丁樱基于“激清扬浊”辨治儿童肾病综合征尿浊经验  

Experience by Professor DING Ying in Treating Proteinuria in Children with Nephrotic Syndrome Based on“Stimulating Purity and Dispelling Turbidity”

作　　者：丁乐乐 韩姗姗[1,2] 魏金辉 郑肖庆 邢亚萍 刘佳佳 白惠文 丁樱(指导)[1] DING Lele;HAN Shanshan;WEI Jinhui;ZHENG Xiaoqing;XING Yaping;LIU Jiajia;BAI Huiwen;DING Ying(Pediatric College,Henan University of Chinese Medicine,Zhengzhou 450046,China;Pediatric Hospital,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450001,China)

机构地区：[1]河南中医药大学儿科医学院,河南郑州450046 [2]河南中医药大学第一附属医院儿科医院,河南郑州450001

出　　处：《山东中医杂志》2023年第8期851-856,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81873343);全国名中医工作室建设项目(批文号:国中医药办人教函﹝2018﹞119号)。

摘　　要：丁樱教授认为,儿童肾病综合征属本虚标实,关键病机为禀赋不足,外邪入里,虚实夹杂,正虚以肺脾肾阳虚为主,标实以外感、水湿、湿热、瘀血为要,重视瘀血在本病中的关键作用;辨证论治时需谨记阴中求阳、阳中求阴、血水相依、风激水浊等关键点。治疗的重点应放在温阳化瘀上,提出“激清扬浊,调和阴阳”的治疗原则,在准确辨证的基础上,针对不同兼证,综合运用疏风清热、祛湿通络等法以扬浊,缓解尿浊症状,尽可能减少精微流失,减轻其对机体正气的损害;整个治疗过程关键在于调整阴阳,使阴平阳秘,清源洁流,增强肺脾肾水液代谢功能,减少病情反复。同时创新应用雷公藤多苷。并以现代研究成果为佐证,极大地提高了临床疗效。Professor DING Ying holds that pediatric nephrotic syndrome is deficient in the root and excessive in the branch,and the key disease mechanism is deficient endowment with internal invasion of external evil,manifesting as mixed deficiency and excess.Deficiency of healthy qi mainly involves yang deficiency of lung,spleen and kidney,and excessive branch mainly involves external attack,water dampness,damp heat and blood stasis which is emphasized for it plays a key role in pediatric nephrotic syndrome.In the syndrome differentiation and treatment,seeking yang from yin,seeking yin from yang,blood water interdependence and wind stimulating and water turbidity should be followed,and warming yang and resolving stasis should be emphasized,and therefore Professor Ding proposes the treatment principle of“stimulating purity and dispelling turbidity,regulating yin and yang”.On the basis of accurate syndrome differentiation,according to different concurrent syndromes,dispersing wind and clearing heat,removing dampness and dredging channel should be applied for dispelling turbidity and eliminating urine turbidity,so as to minimize the loss of essence and reduce damages to the healthy qi as much as possible.The key of the whole treatment process is to regulate yin and yang so as to pacify yin and consolidate yang,clear the source and clean the stream,improve the metabolism of body fluids by lung,spleen and kidney,and reduce disease recurrence.Besides,tripterygium glycosides has been applied innovatively.The clinical efficacy has been greatly improved with the assistance and verification of modern research results.

关 键 词：激清扬浊 小儿肾病综合征 尿浊 丁樱 国医大师 名医经验 

分 类 号：R249[医药卫生—中医临床基础] R256.5[医药卫生—中医学]