基于“伏邪理论”探析IgA肾病“火伏肾络”的中医病机及治疗  

Discussion on TCM Pathogenesis"Fire Evil Hidden in Renal Collateral"and Treatment of IgA Nephropathy Based on"Hidden Pathogen"

作　　者：王英明 闫燕顺 程建林 李建省[3] WANG Yingming;YAN Yanshun;CHENG Jianlin;LI Jiansheng(Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;Gansu University of Chinese Medicine,Lanzhou 730030,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院,甘肃兰州730050 [2]甘肃中医药大学,甘肃兰州730030 [3]甘肃省中医院,甘肃兰州730050

出　　处：《西部中医药》2025年第4期9-12,共4页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82360884);国家中医药管理局青年岐黄学者支持项目(国中医药人教函〔2020〕218号);甘肃省自然科学基金(20JR5RA162,1308RJZA164);甘肃省中医药科研项目(重点课题)(GZKZ-2022-3);甘肃省高等学校科研项目(2013A-082)。

摘　　要：IgA肾病病位在肾,是以微血管病变为特征,肾内微小血管与肾络相符合,其临床以大量血尿为表现,火性炎热易迫血妄行,故从“伏邪理论”中“火伏肾络”的角度出发可认为火伏肾络、热迫血行是血尿的主要病机,真阴耗伤、虚火妄动是炎症反应的关键,肾络灼伤、脉络瘀阻是肾功能衰竭的基础。在治疗上可采用补肾透邪、养阴清热、止血养血、畅通肾络、升清降浊、协调脏腑的原则,以期为中医深入认识IgA肾病及治疗提供理论依据和新的思路。IgA nephropathy,located in the kidney,is characterized by microvascular lesions,with its clinical manifestation of large amounts of hematuria,intrarenal microvessels conform to renal collateral,fire is hot and easily forces blood to flow uncontrollably,hence,from the perspective of"fire evil hidden in renal collateral"in the theory of"hidden pathogen",it is believed that fire evil hidden in renal collateral,and fire easily forces blood to flow uncontrollably is the main pathogenesis of hematuria,the depletion of true Yin,and flaring up of deficiency fire is the key to inflammatory response,burns of renal collateral and the obstruction of the vein and collateral is the foundation of renal failure.Therapeutic principles of the disease could adopt tonifying-kidney and eliminating the pathogen,nourishing Yin and clearing heat,stopping bleeding and benefiting blood,unobstructing renal collateral,ascending the clear and descending the turbid and coordinating the viscera,so as to provide theoretical reference for the insight into IgA nephropathy in TCM and the treatment.

关 键 词：IGA肾病 伏邪理论 火伏肾络 病机 治疗 

分 类 号：R256.51[医药卫生—中医内科学]