基于固本培元理论探析肾病综合征的中医防治策略  

Exploration of TCM Prevention and Treatment Strategies for Nephrotic Syndrome based on the Theory of Guben Peiyuan

作　　者：刘政新 朱佩琦 尹晓凡 何伟明[2] LIU Zhengxin;ZHU Peiqi;YIN Xiaofan;HE Weiming(The First Clinical Medical College of Nanjing University of Chinese Medicine,Jiangsu Nanjing 210029,China;The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu Provincial Hospital of Traditional ChineseMedicine,Jiangsu Nanjing 210029,China)

机构地区：[1]南京中医药大学第一临床医学院,江苏南京210029 [2]南京中医药大学附属医院,江苏省中医院,江苏南京210029

出　　处：《中医药临床杂志》2024年第9期1642-1646,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：2021年江苏省中医院项目(y2021rc16)。

摘　　要：基于新安固本培元理论治疗肾病综合征,肾病综合征是常见肾系系统疾病,归属祖国医学中的“水肿”范围,正气不足是肾病综合征发病的根本因素,脾肾亏虚是导致肾病综合征的重要因素,从现代临床诊断角度来看,低蛋白血症以及水肿的产生多是因为大量蛋白质从尿液中丢失所致,中医认为蛋白乃是精微之物,精微下泄,与脾肾关系最大。利用固本培元法针对肾病综合征分析施治,通过补益脾肾、培养元气的方法达到退水肿、摄精微、扶正气的目的。另外,正气不足,脾肾亏虚,脏腑功能失调,常常因虚致病,故在治疗之时需要考虑痰饮、瘀血的形成。具体治疗法则为,补脾益肾以固本利水,以参附汤、金匮肾气汤等为代表方剂,培元之法应贯穿始终,培补中焦以充元气,主以人参、黄芪为主,培补下焦元气多以参芪术配伍姜附桂以补肾培元,同时注意使用温阳利水药以及活血化瘀药的使用。Based on the theory of strengthening the foundation and nourishing the essence,nephrotic syndrome is treated.Nephrotic syndrome is a common renal system disease,which belongs to the category of“edema”in traditional Chinese medicine.Insufficient vital energy is the fundamental factor of nephrotic syndrome,and spleen and kidney deficiency is an important factor leading to nephrotic syndrome.From the perspective of modern clinical diagnosis,hypoproteinemia and edema are mostly caused by the loss of a large amount of protein from the urine.Chinese medicine believes that protein is a fine substance,and the fine substance is discharged downward,which is most related to the spleen and kidney.The method of strengthening the foundation and nourishing the essence is used to analyze and treat nephrotic syndrome.The purpose of reducing edema,absorbing fine substance,and supporting vital energy is achieved by replenishing the spleen and kidney and cultivating vital energy.In addition,insufficient vital energy,spleen and kidney deficiency,and visceral dysfunction often cause diseases due to deficiency,so the formation of phlegm and blood stasis needs to be considered during treatment.The specific treatment principle is to nourish the spleen and kidney to consolidate the foundation and promote diuresis,with Shenfu Decoction and Jinkui Shenqi Decoction as representative prescriptions.The method of nourishing the essence should be carried out throughout,nourishing the middle burner to replenish the vital energy,mainly with ginseng and astragalus,and nourishing the lower burner with ginseng,astragalus,ginger,atractylodes and cinnamon to nourish the kidney and nourish the essence.At the same time,pay attention to the use of warming Yang and promoting diuresis and blood circulation and blood stasis removal drugs.

关 键 词：健脾益肾 固本培元 肾病综合征 

分 类 号：R259[医药卫生—中西医结合]