基于营卫理论探讨IgA肾病辨治  

Differentiation and treatment of IgA nephropathy based on nutrient-defense theory

作　　者：都洁丽 刘宝利[2] 赵启涵 戴浩然 DU Jieli;LIU Baoli;ZHAO Qihan;DAI Haoran(Beijing University of Chinese Medicine,Beijing 100105,China;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010)

机构地区：[1]北京中医药大学,北京100105 [2]首都医科大学附属北京中医医院,北京100010

出　　处：《北京中医药》2025年第2期132-136,共5页Beijing Journal of Traditional Chinese Medicine

摘　　要：IgA肾病是我国最为常见的原发性肾小球疾病,IgA肾病的发病多与黏膜免疫相关。本文以营卫理论为基础探析IgA肾病的发病机理,认为营卫失和贯穿IgA肾病始终。其具体机制为营卫失和,外有邪气客伤肌表,卫气失司,营气郁滞,内有脾肾亏虚,营卫生化无源,伏邪藏于营卫之间,气血津液运行失常,内外相合,病理产物蓄积,肾络受损而发为本病。临床治疗提出以调和营卫为基本治法,分期辨治IgA肾病,急性期祛邪为主,疏风祛邪,慢性期扶正为主,温肾健脾,为临床中医药治疗IgA肾病提供新思路。IgA nephropathy is the most common primary glomerular disease in China,with its onset closely related to mucosal immunity.Based on the nutrient-defense theory,this study explores IgA nephropathy and posits that nutrient-defense disharmony persists throughout the disease course.The specific mechanism involves nutrient-defense imbalance,with external pathogenic qi invading the muscular surface,leading to defensive qi dysfunction and nutrient qi stagnation.Internally,spleen and kidney deficiency results in the inadequate generation of nutrient and defense,causing hidden pathogens to be trapped between them.This disrupts the normal circulation of qi,blood,and body fluids.The interplay of internal and external factors leads to the accumulation of pathological substances,damage to the kidney collaterals,and ultimately the development of the disease.In clinical treatment,harmonizing nutrient and defense is proposed as the fundamental therapeutic principle,with a stage-based differentiation and treatment approach for IgA nephropathy.During the acute phase,the primary strategy is to expel pathogens and facilitate their elimination.In the chronic phase,the focus shifts to strengthening the healthy qi by warming the kidneys and invigorating the spleen.This study is expected to provide a novel perspective for the clinical treatment of IgA nephropathy with traditional Chinese medicine.

关 键 词：IGA肾病 营卫失和 黏膜免疫 调和营卫 中医病机 

分 类 号：R277.5[医药卫生—中医学]