益气祛风化瘀清利法治疗肾病综合征验案撷菁  

The experience for treating nephrotic syndrome by the Yiqi Qufeng Huayu Qingli method

作　　者：赵令富 周恩超[1] ZHAO Lingfu

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中医临床研究》2023年第32期118-122,共5页Clinical Journal Of Chinese Medicine

基　　金：江苏省中医院院内人才高峰项目(y2021 rc26)。

摘　　要：肾病综合征是多种病理损害所致的一组临床综合征,主要表现为大量蛋白尿、低白蛋白血症、水肿及/或高脂血症,是临床上治疗较为棘手的疾病之一。目前现代医学针对肾病综合征主要使用激素和免疫抑制剂治疗,往往面临感染风险高以及不良反应大等问题,且疗效欠佳。周恩超教授以中医药治疗肾脏病近30年,临床经验丰富。周恩超教授认为肾病综合征的基本病机总属本虚标实,本虚总不离肺、脾、肾三脏功能失调,气血阴阳虚损;标实不外乎风、瘀、湿等因素,提出运用益气祛风化瘀清利法治疗本病,在治疗上强调健脾益肾扶助正气,注重祛风通络兼顾化瘀,佐以淡渗清利畅通三焦;在用药方面,常以生黄芪、太子参、炒白术、酒萸肉等益气健脾补肾扶固正气,以全蝎、僵蚕、蝉蜕、雷公藤、青风藤等以祛风通络,配伍红花、川芎、土鳖虫以活血化瘀,取茯苓皮、车前子、石韦、益母草、玉米须等以淡渗清利,往往能够取得良好效果。文章结合临床案例阐述周恩超教授治疗肾病综合征相关学术观点及用药经验,以期为临床治疗肾病综合征提供参考。Nephrotic syndrome is a group of clinical syndromes caused by various pathological lesions,mainly manifested by massive proteinuria,hypoalbuminemia,edema and/or hyperlipidemia.This disease is one of the more difficult diseases to treat clinically.At present,modern medicine mainly uses hormones and immunosuppressants to treat nephrotic syndrome,which often face problems such as high risk of infection and great adverse reactions,and the efficacy is not good.Professor ZHOU Enchao has been treating kidney disease in TCM medicine for nearly 30 years,and has rich clinical experience.Professor ZHOU Enchao believes that the basic pathogenesis of nephrotic syndrome is mainly deficient root and excessive exter symptoms.Deficient root mainly refers to the dysfunction of the three viscera of lung,spleen and kidney,resulting in deficiency of Qi(气),blood and Yin(阴)and Yang(阳).Excessive exter symptoms mainly refer to wind,blood stasis,dampness and other factors.It is proposed to treat this disease by the Yiqi Qufeng Huayu Qingli method(益气祛风化瘀清利法).In the treatment,the method of strengthening spleen and kidney is emphasized to strengthen healthy Qi,and eliminating wind and dredging meridian collaterals is paid attention to,accompanied by dehumidification to dredge Sanjiao(三焦).In terms of medication,medicines such as Sheng Huangqi(Radix Astragali),Taizishen(Radix Pseudstellariae),Chao Baizhu(Rhizoma Atractylodis Macrocephalae),and Jiu Yuyou(Fructus Corni)are often used by Professor ZHOU Enchao to strengthen Qi,tonify spleen and kidney.Quanxie(Scorpio),Jiangchan(Bombyx Batryticatus),Chantui(Periostracum Cicadae),Leigongteng(Radix et Rhizoma Tripterygii),Qingfengteng(Caulis Sinomenii)and so on are often used to dispel wind and open collaterals,accompanied by Honghua(Flos Carthami),Chuanxiong(Rhizoma Chuanxiong)and Tubiechong(Eupolyphaga Seu Steleophaga)to promote blood circulation and remove blood stasis.Fulingpi(Poria),Cheqianzi(Semen Plantaginis),Shiwei(Folium Pyrrosiae),Yimucao(Herba Leonuri),Yumixu(St

关 键 词：肾病综合征 中医药疗法 验案 名医经验 

分 类 号：R692[医药卫生—泌尿科学]