赵菁莉运用茵陈失笑散治疗慢性肾脏病验案  

Test cases of treating chronic kidney disease with Yinchen Shixiao San of ZHAO Jingli

作　　者：盛新 赵菁莉[1] SHENG Xin;ZHAO Jingli

机构地区：[1]天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津300382

出　　处：《中医临床研究》2024年第33期60-62,共3页Clinical Journal Of Chinese Medicine

摘　　要：慢性肾脏病(Chronic Kidney Disease, CKD)指肾脏出现3个月以上结构或者功能异常。本病患病率逐年升高,已经成为我国重要的公共卫生问题。中医对该病的治疗尤其有优势,通过中西医结合诊疗能够延缓肾功能下降的进展,延长患者进入肾脏替代治疗的时间。茵陈失笑散是由国医大师张大宁创立的时方,长于清热利湿、祛瘀降浊,针对CKD湿浊瘀阻证疗效确切。赵菁莉老师在临床中取其茵陈、五灵脂、蒲黄炭、大黄四味主药作为治疗CKD的常用底方,能够改善患者临床症状,稳定患者肌酐水平,有效保护患者肾功能,对CKD有确切的治疗作用。在CKD整体的中医治疗上,赵老师基于“疏利三焦”理论,将活血利湿治则贯穿治疗全程,以通利三焦为主要祛邪之法,处方上君、臣、佐、使严谨,擅长化用各种经方与时方中的主药为药对,结合患者的症状与体质灵活调整,并重视佐使药物的使用,在药物的治疗效果与不良反应中寻求平衡,体现了中医辨证论治与整体观念的特色。现以赵老师运用茵陈失笑散治疗的1例CKD病例为引,阐述茵陈失笑散在CKD治疗中的具体运用,以及其中体现出的赵菁莉老师对于CKD中医治疗的整体思路,以资同道。Chronic kidney disease refers to the abnormal structure or function of the kidney for more than three months.With the increasing prevalence year by year,the disease has become an important public health problem in China,and traditional Chinese medicine has unique advantages in the treatment of the disease.Through the combination of traditional Chinese medicine and Western medicine,it can delay the progress of renal function decline and prolong the time for patients to enter renal replacement therapy.Yinchen Shixiao San(茵陈失笑散)was established by TCM master ZHANG Daning.It is good at clearing heat and dampness,removing blood stasis and reducing turbidity,and has a definite curative effect on dampness and stasis obstruction syndrome of chronic kidney disease.ZHAO Jingli takes the four main medicials of Yinchen(Herba Artemisiae Scopariae),Wulingzhi(Faecas Trogopterori),Puhuangtan(Carbo of Pollen Typnae)and Dahuang(Radix et Rhizoma Rhei)as the commonly used basic prescription for the treatment of chronic kidney disease in clinical practice,which can relieve the clinical symptoms of patients,stabilize the creatinine level of patients,effectively protect the kidney function of patients,and play an exact therapeutic role on chronic kidney disease.In the overall treatment of chronic kidney disease in traditional Chinese medicine,based on the theory of‘clearing heat and dampness in Sanjiao’,Mentor ZHAO takes promoting blood circulation and removing dampness as the treatment principle throughout the treatment process,and‘clearing heat and dampness in Sanjiao’as the main method of dispelling evil.The prescription is meticulous in its combination of monarch,minister,assistant,and envoy medicinals and Mentor ZHAO is skilled at transforming the main ingredients from various classic and modern prescriptions into pairs of medicinals.The flexible adjustment is combined with the patient’s symptoms and physique,and the use of adjuvant drugs is highly valued to obtain the balance between the therapeutic effects and

关 键 词：慢性肾脏病 茵陈失笑散 验案 

分 类 号：R256.5[医药卫生—中医内科学]