基于“治水者必先治气”辨治特发性膜性肾病  

Identification and Treatment of Idiopathic Membranous Nephropathy Based on the Principle of "Treating Water Must be Preceded by Treating Qi"

作　　者：刘浩宇 王浩[1] 张嘉宁 李爱峰[1] LIU Haoyu;WANG Hao;ZHANG Jianing;LI Aifeng(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091)

机构地区：[1]中国中医科学院西苑医院,北京市100091

出　　处：《中医杂志》2024年第21期2259-2263,共5页Journal of Traditional Chinese Medicine

基　　金：中国中医科学院科技创新工程课题(CI2021A01205);中国中医科学院西苑医院名老中医经验传承研究专项(XYZX0101-17)。

摘　　要：认为气结水停是特发性膜性肾病的主要病机。临证以“治水者必先治气”为指导,结合特发性膜性肾病的临床特点,主张运用调气法治疗。根据各脏腑气机失调的不同表现,采用健脾升清、和胃降浊,提壶揭盖、宣肺利水,助阳化气、利水消肿,疏肝解郁、调畅气机,通利三焦、以助气化的不同治法,灵活选用补中益气汤、升阳益胃汤、防己黄芪汤、当归芍药散、中满分消丸等方剂,使气机恢复和畅,水肿自消。It is believed that the main mechanism of idiopathic membranous nephropathy is the stagnation of qi and water.The clinical practice is guided by the principle of"treating water must be preceded by treating qi",and combined with the clinical characteristics of idiopathic membranous nephropathy,which advocated that qi regulation should be applied in the treatment of idiopathic membranous nephropathy.According to the different manifestations of disorder of qi movement in all zang-fu organs,different methods are adopted to strengthen the spleen to raise the clear,harmonise the stomach to reduce turbidity,lift the pot to uncover the lid,diffuse the lung and drain water,assist yang to transform qi,promote water retention and reduce edema,soothe the liver and resolve constraint,regulate qi movement,and promote the sanjiao to help the qi transformation,and prescribed such as Buzhong Yiqi Decoction(补中益气汤),Shengyang Yiqi Decoction(升阳益胃汤),Fangji Huangqi Decoction(防己黄芪汤),Danggui Shaoyao Powder(当归芍药散),Zhongman Fenxiao Pill(中满分消丸)are used flexibly to restore qi movement,and the edema will disappear by itself.

关 键 词：特发性膜性肾病 气机失调 调气 水肿 

分 类 号：R277.5[医药卫生—中医学]