阮诗玮治疗慢性肾炎蛋白尿五法  

Ruan Shiwei Treating Chronic Nephritis Proteinuria with Five Methods

作　　者：吴美琴 高嘉玮 阮诗玮[1] WU Meiqin;GAO Jiawei;RUAN Shiwei(The People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou Fujian China 350004)

机构地区：[1]福建中医药大学附属人民医院,福建福州350004

出　　处：《中医学报》2024年第7期1514-1518,共5页Acta Chinese Medicine

基　　金：阮诗玮全国名老中医药专家传承工作室建设项目{国中医药人教函〔2022〕75号}。

摘　　要：本虚标实为慢性肾炎蛋白尿的基本病机,本虚为肺脾肾虚,以气阴两虚为主,标实为风、湿热、瘀血内结。其中,气阴两虚、湿热内蕴为其常见病机。故疾病初期,标实为主,虚象不显者,以治其标,兼顾其本;疾病后期,本虚为主,标实不显者,以治其本,兼顾其标,是以为治。主要治法为疏风透邪,尤重风药;清热利湿,益气养阴;疏达肝气,调肝消浊;活血通络,祛瘀生新;理脾益肾,收敛固涩。临证应灵活遣方用药,多法并用,主次分明,组方轻灵平和,方能药到病除。Deficiency in root and excess in symptom is the basic pathogenesis of chronic nephritis proteinuria,in which the former is Lung,Spleen and Kidney deficiency with Qi and Yin deficiency as the main syndrome while the latter is Wind,Damp Heat and blood stasis stagnation.Among them,Qi and Yin deficiency as well as Damp Heat are the common pathogenesis.Therefore,in the early stage of the disease,the excess in the main problem and should be dealt with first and foremost important;In the later stage of the disease,the deficiency is the main problem and should be focused on in treatment.The main treatment policy is to dissipate Wind to clear the evil factors,especially with large dose of Wind dispelling medicines,to clear Heat and Dampness,to invigorate Qi and nourish Yin,to regulate Liver Qi to eliminate turbidity,to promote blood circulation and collaterals to remove stasis and generate new blood and to regulate Spleen and tonify Kidney to restrain the Essence.In clinical practice,treatment should be flexible in prescription,with multiple methods and proper medication,the purpose can be achieved eventually.

关 键 词：慢性肾炎 蛋白尿 辨治五法 疏风透邪 尤重风药 清热利湿 益气养阴 疏达肝气 调肝消浊 活血通络 祛瘀生新 理脾益肾 收敛固涩 

分 类 号：R249.27[医药卫生—中医临床基础]