王耀献基于“辨机论治”思想治疗特发性膜性肾病  

Wang Yaoxian′s Treatment Experience of Idiopathic Membranous Nephropathy Based on"Pathogenesis Differentiation and Treatment"

作　　者：陈荟溪 孙卫卫[1,2] 郑慧娟 崔赵丽 张佳乐[1,2,3] 王耀献 CHEN Huixi;SUN Weiwei;ZHENG Huijuan;CUI Zhaoli;ZHANG Jiale;WANG Yaoxian(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing China 100700;Institute of Nephrology,Beijing University of Chinese Medicine,Beijing China 100700;Beijing University of Chinese Medicine,Beijing China 100029;Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学肾病研究所,北京100700 [3]北京中医药大学,北京100029 [4]河南中医药大学,河南郑州450046

出　　处：《中医学报》2024年第5期1002-1007,共6页Acta Chinese Medicine

基　　金：国家自然科学基金项目(82004272);中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者-国家中医药领军人才支持计划项目{国中医药人教发〔2018〕12号};中药新药“病-证-症关联”临床评价技术平台项目(2017ZX09304019)。

摘　　要：王耀献教授论治特发性膜性肾病时,强调从初始病机、衍生病机、微观病机、对证病机等多维度、多角度探索。初始病机的核心为“风湿扰肾”;湿热、瘀血、脾肾虚损是重要衍生病机;“湿热阻滞”和“瘀血阻络”是主要的微观病机;“脾肾气虚,湿郁不化”是最常见的对证病机;另外还有对症病机,环境病机等。辨治核心围绕“风湿扰肾”“湿热阻滞”“瘀血阻络”和“脾肾气虚”几点关键病机要素并兼顾其他病机要素,治以攻补兼施,标本兼顾,驱邪扶正。在实际诊疗中重视患者的主观感受,随症加减处方,缓解临床症状。When Professor Wang Yaoxian discusses the treatment of idiopathic membranous nephropathy,he emphasizes the exploration from multiple dimensions and perspectives such as initial pathogenesis,derived pathogenesis,microscopic pathogenesis and syndrome pathogenesis.The core of the initial pathogenesis is"Wind and Dampness disturbing Kidney";Damp Heat,blood stasis as well as Spleen and Kidney deficiency are important derivative pathogenesis;"Damp Heat blocking"and"blood stasis obstruction"are the main microscopic pathogenesis;"Spleen and Kidney Qi deficiency as well as"Dampness and Depression"are the most common pathogenesis.In addition,there are symptomatic pathogenesis,environmental pathogenesis,etc.The core of the treatment focuses on the key pathogenesis elements of"Wind and Dampness disturbing the Kidney","Damp Heat blocking","blood stasis and obstruction"as well as"Spleen and Kidney Qi deficiency",and other pathogenesis elements should be considered.The treatment should be as follows:tonifying and purgation in combination,root cause and symptoms in combination as well as dispelling evil factor and strengthening Zheng Qi.In the actual diagnosis and treatment,the subjective feelings of patients are emphasized,and the modified prescriptions can be used according to the symptoms to alleviate the clinical symptoms.

关 键 词：特发性膜性肾病 辨机论治 初始病机 衍生病机 微观病机 对证病机 对症病机 王耀献 

分 类 号：R249.27[医药卫生—中医临床基础]