基于“治未病”理论的膜性肾病防治思路  

The Preventive and Therapeutic Approach to Membranous Nephropathy Based on the Theory of"Prevention of Disease Before It Occurs"

作　　者：牛晨媛 刘光珍[2] 孙卫卫[1] NIU Chenyuan;LIU Guangzhen;SUN Weiwei(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700;Shanxi Province Hospital of Traditional Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院,北京市100700 [2]山西省中医院

出　　处：《中医杂志》2025年第5期468-472,共5页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名中医传承工作室建设项目(国中医药办人教函[2022]245号);山西省临床医学研究中心建设项目(202204010501005);山西省科技厅重点研发计划(202102130501012)。

摘　　要：基于治未病理论,从“湿、热、瘀”邪实为本立论,探讨膜性肾病发生、发展的病机及其证候演变过程。未病先防,控制疾病发生可能的危险及继发因素,从充实肺卫、防瘀内阻、早检早防入手,选用玉屏风散、小柴胡汤等方;疾病发展过程中,重视湿、瘀致病的重要作用,治疗从祛湿化浊、清热利湿、凉血化瘀、活血通络、通腑蠲毒立法,选用萆薢分清饮、三仁汤、桃红四物汤等方,同时应积极改善贫血、心血管疾病、骨质疏松等并发症,控制其进展,促进其向愈。从改善膜性肾病患者体质,畅情志、调饮食、防感冒以减少其复发,以期为中医药防治膜性肾病提供参考。Based on the theory of"prevention of disease before it occurs",this paper explores the pathogenesis and progression of membranous nephropathy,focusing on the role of"dampness,heat,and blood stasis"as the fundamental causes.The approach emphasizes early prevention,controlling potential risks and secondary factors for disease occurrence.Starting with reinforcing lung defense,preventing blood stasis,and early detection and intervention,prescriptions such as Yupingfeng Powder(玉屏风散)and Xiaochaihu Decoction(小柴胡汤)are recommended.During disease progression,the significant role of dampness and blood stasis in pathogenesis is highlighted.Treatment strategies focus on eliminating dampness and turbidity,clearing heat and promoting urination,cooling blood and resolving blood stasis,activating blood circulation and unblocking meridians,and detoxifying the bowels.Prescriptions like Bixie Fenqing Decoction(萆薢分清饮),Sanren Decoction(三仁汤),and Taohong Siwu Decoction(桃红四物汤)are used.Concurrently,attention should be given to managing complications such as anemia,cardiovascular diseases,and osteoporosis,controlling their progression,and promoting recovery.The approach also includes improving the patient's constitution,regulating emotions,adjusting diet,and preventing colds to reduce recurrence,providing a reference for the prevention and treatment of membranous nephropathy using traditional Chinese medicine.

关 键 词：膜性肾病 治未病 

分 类 号：R27[医药卫生—中医学]