从“伏毒损络”探析特发性膜性肾病临证法要  

Discussion on treating idiopathic membranous nephropathy from ‘hidden pathogen damaging collaterals'

作　　者：黄思雨 张琳琪[1,2] 陈冠廷 李清茹 陈旭 王希茜 HUANG Siyu;ZHANG Linqi;CHNE Guanting;LI Qingru;CHEN Xu;WANG Xixi(Department of Nephrology,The First Affiliated Hospital of Henan University of CM,Zhengzhou 450000,China;The First Clinical Medicine College,Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院肾病科,郑州450000 [2]河南中医药大学第一临床医学院,郑州450000

出　　处：《中华中医药杂志》2025年第1期226-230,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：第七批全国老中医药专家学术经验继承工作(No.国中医药人教函[2022]76号);河南省中原千人计划-中原名医项目(No.ZYYCYU202012120);国家自然科学基金项目(No.81973806)。

摘　　要：文章总结张琳琪教授治疗特发性膜性肾病的经验。张教授认为该病的核心病机为“伏毒潜内,肾络受损”,病位主要涉及肾络,病因与伏毒密切相关,故病情缠绵复杂。在治疗上以“祛毒透邪,扶正养络”为要,因其病理产物及致病关键是风毒、湿毒、痰毒、瘀毒,故治疗上要疏风透毒、除湿化浊、清热化痰、活血化瘀以祛邪通络,对于长期正气亏虚的患者宜采用滋阴清热或温阳补肾以养肾络,同时在诊疗过程中要重视辛味药和藤类药的运用并注意调理体质及改善生活方式预防其反复。The article summarizes professor ZHANG Linqi's experience in treating idiopathic membranous nephropathy.Professor ZHANG believes that the core pathogenesis of this disease is hidden pathogen accumulation and damage to the renal collaterals.The disease mainly involves the renal collaterals,and the etiology is closely related to hidden pathogen,so the condition is complex.In terms of treatment,the key is to ‘eliminating toxins and pathogens,nourishing the collaterals.As the pathological products and key pathogenic factors are wind pathogen,dampness pathogen,phlegm pathogen,and blood stasis pathogen,it is necessary to expel wind and pathogen,remove dampness and turbidity,clear heat and phlegm,promote blood circulation and blood stasis to expel pathogenic factors and clear collaterals.For patients with long-term deficiency of qi,it is recommended to use nourishing yin and clearing heat or warming yang and tonifying the kidney to nourish the renal collaterals.During the diagnosis and treatment process,attention should be paid to the use of pungent and vine type traditional Chinese medicine,as well as to improving the conditioning and the lifestyle to prevent recurrence.

关 键 词：特发性膜性肾病 伏毒 络病 张琳琪 名医经验 

分 类 号：R277.5[医药卫生—中医学]