摘要
慢性肾炎综合征是以蛋白尿、血尿、水肿、高血压为临床特点的综合征,具有起病隐匿、发展缓慢、病程久远、临床表现多样的特点,属于中医“尿浊”“血尿”“水肿”“腰痛”“虚劳”等病范畴。高智教授是武汉市中医医院肾病科学术带头人、主任医师,兼任湖北中医药大学教授、硕士研究生导师,从事肾病科临床工作30余年,在运用中医、中西医结合防治肾脏疾病方向积累了丰富经验并取得了良好的临床疗效。高智教授认为慢性肾炎综合征总属本虚标实、本虚为主、虚实夹杂,主要病机可概括为肾气不固、阴虚火旺、脾肾两虚、肾虚湿热、肾虚血瘀等方面,认为外感邪气及湿热、瘀毒等病理产物是诱发或加重疾病的重要因素。外邪为患则解表散邪,内伤邪滞则扶正祛邪。强调邪毒为患之际,急则祛邪,慎用补益之剂;缓则兼顾,扶正祛邪随证化裁。在急治标、缓兼顾的治疗原则下,临床上以补肾固精、养阴清热、益肾健脾、清热利湿、益肾祛瘀为法,予以参芪地黄汤、知柏地黄丸合二至丸、益气补肾方、加味四妙散、益肾排毒方等加减处方。文章从高智教授对慢性肾炎综合征中医病因病机的认识、临床辨证论治的思路进行经验总结,并予临床验案加以佐证,供同道参考。
Chronic nephritis syndrome is a syndrome characterized by proteinuria,hematuria,edema and hypertension.It is characterized by insidious onset,slow development,long course of disease and diverse clinical manifestations.It belongs to the categories of turbidity of urine,hematuria,edema,lumbago,and virtual fatigue in traditional Chinese medicine.Professor GAO Zhi is the academic leader and chief physician of the Department of Nephrology in Wuhan Hospital of Traditional Chinese Medicine,a professor and postgraduate tutor of Hubei University of Traditional Chinese Medicine.He has been engaged in clinical work in the department of nephrology for more than 30 years.He has accumulated rich experience in the application of traditional Chinese medicine and the integrative medicine in the prevention and treatment of kidney diseases and has achieved good clinical efficacy.Professor GAO Zhi believes that the pathogenesis of chronic nephritic syndrome is asthenia in origin and asthenia in superficiality,or primary asthenia and secondary asthenia.The main pathogenesis can be summarized as insufficiency of kidney Qi(气),Yin(阴)deficiency and fire,spleen and kidney deficiency,kidney deficiency damp heat,and kidney deficiency and blood stasis.Exogenous pathogenic Qi and pathological products such as damp heat and blood stasis are important factors that induce or aggravate the disease.When the external evil attacks,it is necessary to dispel the surface evil,and when the internal injury is caused by evil poison,it is necessary to promote health and dispel evil spirits.It is emphasized that when evil poison attacks,it is urgent to exorcise evil,and it is prudent to use tonic agents.When it is not urgent,it is urgent to promote healthy Qi and dispel evil spirits based on the syndrome.Under the treatment principle of treating symptoms urgently and giving consideration to the root causes when it is not urgent,the methods of tonifying kidney and strengthening essence,nourishing Yin and clearing heat,invigorating kidney and spleen,clear
作者
娄佐运
熊静
高智
LOU Zuoyun;XIONG Jing;GAO ZHI
出处
《中医临床研究》
2023年第12期95-98,共4页
Clinical Journal Of Chinese Medicine
关键词
慢性肾炎综合征
病因病机
临床经验
Chronic nephritis syndrome
Etiology and pathogenesis
Clinical experience
