摘要
[目的]介绍周恩超教授运用益肾解毒法分期治疗慢性肾衰竭经验。[方法]结合中医经典理论及门诊跟师学习,通过分析肾功能代偿期、失代偿期、衰竭期3则代表性验案,阐明周恩超教授运用益肾解毒法论治慢性肾衰竭的经验。[结果]慢性肾炎引起的肾功能代偿期医案一则,辨证属脾肾气虚、湿浊内蕴,从肺、脾、肾三脏论治,益气养阴,化湿解毒;由糖尿病肾病引起肾功能失代偿期医案一则,辨证为脾肾气阴两虚、湿热瘀浊内蕴,拟健脾补肾、益气滋阴、清利湿热、和络泄浊法从治;肾功能衰竭期医案一则,辨证为脾肾气阴两伤、湿浊瘀毒互结,治从健脾补肾、调补气阴,兼清利活血、化湿解毒。周恩超教授认为慢性肾衰竭基本病机为脾肾衰惫,邪毒内蕴。风、热、水、湿、痰、瘀、浊毒既是慢性肾衰的病理产物,又是加重疾病发展的病理因素。健脾补肾、化浊解毒为基本治疗方法,临证应分清邪毒的轻重浅深、标本缓急,早期祛邪为先,中后期标本兼顾,强调从'毒'论治,临床取得满意的疗效。[结论]周恩超教授按照慢性肾衰不同阶段的特点分期论治,疗效显著,其经验值得学习和推广。
[Objective]To introduce the experience of Professor ZHOU Enchao in treating chronic renal failure by stages using the Yishenjiedu method.[Methods]Based on the classic theory of traditional Chinese medicine and the study in the outpatient department,the author analyzed three representative cases of chronic renal function in compensation period,decompensation period and exhaustion period,and expounded the experience of Professor ZHOU Enchao in treating chronic renal failure by the method of Yishenjiedu.[Results]In this paper,a medical case of renal function in compensation period caused by chronic nephritis was selected.The syndrome differentiation,was spleen-kidney Qi deficiency,dampness and turbidity retention,which was treated from the three internal organs of lung,spleen and kidney to improve Qi and nourish Yin,remove toxin and dampness.These medical cases were caused by diabetic nephropathy,which was characterized by deficiency of spleen and kidney Qi and Yin,dampness and heat stasis and turbidity accumulation.It was proposed to invigorate the spleen and tonify the kidney,benefit Qi and Yin,clear dampness and heat,and harmonize collateral and remove turbidity.Choose a case of renal failure for syndrome differentiation,spleen and kidney Qi Yin were both injured,also with the implication of dampness,turbidity,blood stasis and toxin.Treatment from spleen and kidney tonifying,regulating Qi Yin,also clearing damp-heat and activating blood circulation,dampness detoxification,ZHOU Enchao believed that the basic pathogenesis of chronic renal failure was the dysfunctions of spleen and kidney.Wind,heat,water,dampness,phlegm,blood stasis and turbidity were the pathological products of chronic renal failure and the pathological factors that aggravated the development of the disease.Strengthening spleen and nourishing kidney,also removing turbidity and detoxification were the basic methods of treatment.It is necessary to distinguish the severity of pathogenic toxin and the weakness of habitus,also urgency of clinical syndr
作者
祝一叶
周恩超
ZHU Yiye;ZHOU Enchao(Graduate School of Nanjing University of Traditional Chinese Medicine,Nanjing 210029)
出处
《浙江中医药大学学报》
CAS
2019年第9期971-974,共4页
Journal of Zhejiang Chinese Medical University
基金
国家自然科学基金项目（81873270）
江苏省“六大人才高峰”高层次人才项目（WSN-012）
江苏省中医院“高峰学术”人才项目(y2018rc17)~~
关键词
慢性肾衰竭
周恩超
益肾解毒法
分期论治
名医医案
chronic renal failure
ZHOU Enchao
Yishenjiedu
treatment by different stages
famous doctor’s experience
