张昱教授基于“固精减毒”论治肾病蛋白尿的经验  

Professor Zhang Yu’s experience in treating nephrotic proteinuria based on“strengthening essence and reducing toxicity”

作　　者：张琪 张昱[1] ZHANG Qi;ZHANG Yu(Department of Nephropathy,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院肾病科,北京100091

出　　处：《中国医药导报》2023年第24期140-143,173,共5页China Medical Herald

基　　金：北京市科技计划课题首都临床诊疗技术研究及示范应用项目(Z191100006619063);广东省新黄埔中医药联合创新项目(2021IR009);中国中医科学院科技创新工程项目(CI2021A01206)。

摘　　要：蛋白尿是慢性肾脏病患者临床治疗的重要观察指标,不仅能反映肾脏损伤,而且对肾脏有毒性作用,是终末期肾脏病最强的预测因子。因此,如何消除蛋白尿对慢性肾脏病患者至关重要。张昱教授认为蛋白尿的产生以脾肾亏虚、肺气不利为根本,同时兼有风湿瘀邪之毒的诱发。因此从“固精减毒”角度探讨总结补肾益元法、健脾培土法、宣肺清利法、祛风解毒法、化湿泄浊法、逐瘀解毒法六法,诸法并举,交替使用,以达“固精扶其本,祛邪防其变”,为肾病蛋白尿临床遣方用药提供更广阔的思路。Proteinuria is an important observation index for clinical treatment of chronic kidney disease patients.It can not only reflect kidney damage,but also has toxic effects on the kidney.It is the strongest predictor of end-stage kidney disease.Therefore,how to eliminate proteinuria is very important for patients with chronic kidney disease.Professor Zhang Yu believes that the production of proteinuria is based on the deficiency of spleen and kidney,the disadvantage of lung qi,and is also induced by the toxin of rheumatism and blood stasis.Therefore,this article explores and summarizes the six methods of tonifying the kidney and nourishing the yuan,strengthening the spleen and nourishing the earth,promoting lung and clearing diuresis,dispelling wind and detoxifying,resolving dampness and turbidity,and removing blood stasis and detoxifying from the perspective of“strengthening essence and reducing toxicity”.All methods should be carried out simultaneously and used alternately to achieve the goal of“strengthening the essence and supporting the root,eliminating pathogenic factors and preventing the change”,and provide a broader idea for clinical prescription of nephrotic proteinuria.

关 键 词：慢性肾脏病 蛋白尿 固精减毒 精微 邪毒 

分 类 号：R256.5[医药卫生—中医内科学]