摘要
阮诗玮教授通过梳理伏邪的定义,认为伏邪的致病特点包括:伏邪致病,隐匿难除;伏邪所藏,病位多端;伏邪所发,正虚邪盛。伏邪在慢性肾脏病中,可伏藏于如下病位:邪伏少阴、邪伏膜原、邪伏营血、邪伏肾络、邪伏三焦。慢性肾脏病的病机在于脾肾亏虚,三焦气化无权,清气不升,浊气不降,湿毒瘀互结所致。其病机总以正虚邪盛为主,常兼有多焦、多脏腑之病变,正虚为伏邪致病之本,邪盛为其标,治疗以扶正祛邪为大法,以透发为贵。阮教授擅从伏邪角度治疗慢性肾脏病,提出的正邪辨证法,在该病的治疗上起到提纲挈领之作用,临床上需掌握扶正与祛邪之法度,切不可过于攻伐,以伤正气。正虚之处,亦是容邪之处,故阮老师临床上以顾护先后天为要,在病情稳定之时,以固本培元为主,兼以祛邪;发作之时,可扶正祛邪兼顾,或以祛邪为主,兼以扶正。阮老师治疗慢性肾脏病还常伍以风药,重视顾护津液、截断病邪传变、辨证与辨病相结合。
By sorting out the definition of latent pathogen,Professor Ruan Shiwei believes that the pathogenic characteristics of latent pathogen include:latent pathogen hides in many disease locations;the occurrence of latent pathogen is due to deficient healthy qi and excessive pathogens.In terms of chronic kidney disease(CKD),latent pathogen can hide in the following locations:lesser yin,mem-branogen,nutrient-blood,kidney collaterals,and triple energizer.The pathogenesis of CKD lies in the deficiency of spleen and kidney,the triple energizer's failure in qi transformation,lucid qi failing to ascend,turbid qi failing to descend,intermingled dampness and toxin and blood stasis.In general,the pathogenesis of CKD is deficient healthy qi and excessive pathogens,often combined with multi-energi-zer,multiple viscera lesions.Deficient healthy qi is the root of pathogenic latent pathogen,while excessive pathogens are the incidental,so the treatment should focus on strengthening healthy qi,expelling and dispersing pathogens.Professor Ruan is good at treating CKD from the angle of latent pathogen,and the dialectical method of healthy qi and pathogens he has put forward plays an important role in the treatment of the disease.However,it is necessary to master the method of strengthening healthy qi and dispelling pathogens in clini-cal practice,and it must not be too aggressive to harm healthy qi.The place of the deficiency of healthy qi is also the location of latent pathogen,so Professor Ruan pays more attention to protecting acquired essence.When the patient condition is stable,consolidating the base and strengthening the origin is mainly used,combined with dispelling pathogens.When CKD occurs,both strengthening healthy qi and expelling pathogens can be used,or expelling pathogens is mainly adopted,combined with strengthening healthy qi.Professor Ruan often combines wind drugs,emphasizes protecting body fluid in order to prevent pathogenic transmission and change,realize combination of syndrome differentiation and disease different
作者
吴美琴
高嘉玮
阮诗玮
WU Meiqin;GAO Jiawei;RUAN Shiwei(The People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian,China,350004)
出处
《河南中医》
2023年第10期1502-1506,共5页
Henan Traditional Chinese Medicine
基金
福建闽山中医肾病学术流派传承工作室项目[闽卫中医(2019)129号]
阮诗玮全国名老中医药专家传承工作室建设项目[国中医药人教函[2022]75号]。
关键词
慢性肾脏病
伏邪理论
伏邪
邪伏少阴
邪伏膜原
邪伏营血
邪伏肾络
邪伏三焦
阮诗玮
chronic kidney disease(CKD)
latent pathogen theory
latent pathogen
latent pathogen of lesser yin
latent pathogen of membranogen
latent pathogen of nutrient-blood
latent pathogen of kidney collaterals
latent pathogen of triple energizer
Ruan Shiwei
