基于玄府开阖不利探讨IgA肾病的中医辨治思路  

Exploring Idea of Traditional Chinese Medicine Treatment of IgA Nephropathy Based on Unfavorable Opening and Closing of Xuanfu

作　　者：任雪雷 王宇阳[1] 杨丽平[1] 冒慧敏[1] 任飞鸿 汤文丽 马放[1] 占永立[1] REN Xuelei;WANG Yuyang;YANG Liping;MAO Huimin;REN Feihong;TANG Wenli;MA Fang;ZHAN Yongli(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《辽宁中医杂志》2024年第9期26-29,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82074393,82204905)。

摘　　要：从刘完素玄府进一步阐发,认为玄府开阖不利是“玄闭”的内涵,非独因阖而闭。玄府开阖不利贯穿IgA肾病全过程,肺肾气虚、外玄开阖不利、风热毒乘虚而入是始动机制,热毒伏里、内玄因郁而闭关乎病势进展,痰瘀胶阻、内玄痿废而闭、兼有神机不遂,是IgA肾病进展的结局。作者以疏通玄府为IgA肾病的基本辨治思路,分6个层次详述具体治法。“通玄”常融合多法,首重辛药直接开通。但不囿于辛通一端,认为以补为通及清除浊瘀等病理产物的间接通玄法亦甚关键,根本目的是恢复气血流通、神机运转。It further elaborated from LIU Wansu′s Xuanfu,and concluded that the unfavorable opening and closing of Xuanfu is the connotation of“closed Xuanfu”,which is not closed only because of closing,and the unfavorable opening and closing of Xuanfu permeates the entire process of IgA nephropathy.The deficiency of lung and kidney Qi,unfavorable opening and closing of the external Xuanfu,and the entry of wind and heat toxinare the initiating mechanisms.Heat and toxin in the interior and the closed internal Xuanfu due to depression are related to the progression of the disease.Phlegm and stagnation,the impotent and closed internal Xuanfu and a failure of regulating the spirit,are the end of the progression of IgA nephropathy.The basic treatment idea for IgA nephropathy is to unblock Xuanfu,and the specific treatment is described in six levels.The“dredging Xuanfu”method often integrates multiple methods,with the primary focus on the direct opening of pungent drugs,but not limited to this.The indirect method of dredging Xuanfu,which uses tonifying drugs as a means of opening and removing turbid stasis and other pathological products,is also crucial,restoring the flow of Qi and blood and the function of kidney Qi is the fundamental purpose.

关 键 词：玄府理论 IGA肾病 治疗思路 血尿 蛋白尿 

分 类 号：R256.5[医药卫生—中医内科学]