摘要
特发性膜性肾病是一种常见的原发性自身免疫性肾小球疾病,本病从脾论治不仅有中医理论渊源,且“脾”与人体的免疫功能密切相关。脾虚不仅涉及人体细胞免疫和体液免疫的紊乱,而且属于“脾”的肠道菌群也影响宿主的免疫稳态。中国中医科学医院西苑医院肾病科主任余仁欢教授经过多年临床实践,依据李东垣的“阴火论”提出脾虚是特发性膜性肾病的基本病机,脾虚不仅生湿,而且以脾胃为中心的中焦气机升降失常,会进而导致三焦气机郁滞,气滞血瘀,气郁化火,变证丛生,从而在脾虚或脾肾两虚基础上,常可兼夹风湿、湿瘀互结、或痰瘀互结。采用健脾益气、疏风散火、祛湿和络法治疗特发性膜性肾病,临床疗效显著,患者尿蛋白明显减少,不良反应少,生活质量明显改善。该文旨在详细阐述余仁欢教授从脾论治特发性膜性肾病的理论依据及临证经验,并验案一则加以佐证。
Idiopathic membranous nephropathy(IMN)is a common primary autoimmune glomerular disease.The treatment of IMN by regulating the balance of“spleen”is based on the theory of traditional Chinese medicine,moreover“spleen”is closely related to the immune function of modern medicine.Spleen deficiency not only involves the disorder of cellular immunity and humoral immunity,but also affects the immune homeostasis of the host by the intestinal flora,which belongs to the function of spleen.After years of clinical practice,professor YU Renhuan,the director of nephrology department of Xiyuan Hospital of Chinese Medical Science Hospital considered that spleen deficiency is the basic pathogenesis of IMN according to LI Dongyuan′s“Yin firetheory”.Spleen deficiency not only leads to dampness,but also causes the abnormal rise and fall of Zhongjiao Qi,and then leads to stagnation of Sanjiao Qi stagnation and blood stasis.Qi stagnation can cause fire,and there are different types of syndromes.Therefore,on the basis of spleen deficiency or spleen and kidney deficiency,wind and dampness,dampness and blood stasis,or phlegm and blood stasis can be combined together.The treatment of IMN of invigorating spleen and supplementing Qi,dispersing wind and fire,removing dampness to harmonize the collaterals has significant clinical efficacy,which can significantly reduceurinary protein,decrease adverse reactions and significantly improve the quality of life.The purpose is to elaborate professor YU Renhuan′s theoretical basis and clinical experience on treating IMN from the perspective of spleen,and an empirical case was used to prove it.
作者
史素琴
邢立军
余仁欢
SHI Suqin;XING Lijun;YU Renhuan(The First Affiliated Hospital of Henan University ofChinese Medicine,Zhengzhou 450000,Henan,China;Mudanjiang Hospital of Traditional Chinese Medicine,Mudanjiang 157005,Heilongjiang,China;Xiyuan Hospital,China Academy of China Medical Sciences,Beijing 100091,China)
出处
《辽宁中医杂志》
CAS
2023年第1期27-30,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
国家重点研发计划项目(2019YFC1708503)。
关键词
从脾论治
特发性膜性肾病
余仁欢
treatment from spleen
idiopathic membranous nephropathy
YU Renhuan
