中国中医科学院西苑医院,北京市海淀区西苑操场1号,100091
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收稿:2023-02-04,
修回:2023-04-29,
纸质出版:2023-07-02
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张丽.安效先从热、湿、瘀、虚论治儿童肾性血尿经验[J].中医杂志,2023,64(13):1312-1316.
ZHANG Li.AN Xiaoxian's Experience in Treating Children's Renal Hematuria from Heat, Dampness, Stasis and Deficiency[J].Journal of Traditional Chinese Medicine,2023,64(13):1312-1316.
张丽.安效先从热、湿、瘀、虚论治儿童肾性血尿经验[J].中医杂志,2023,64(13):1312-1316. DOI: 10.13288/j.11-2166/r.2023.13.004.
ZHANG Li.AN Xiaoxian's Experience in Treating Children's Renal Hematuria from Heat, Dampness, Stasis and Deficiency[J].Journal of Traditional Chinese Medicine,2023,64(13):1312-1316. DOI: 10.13288/j.11-2166/r.2023.13.004.
总结安效先教授从热、湿、瘀、虚论治儿童肾性血尿的临证经验。认为儿童肾性血尿的核心病机为热、湿、瘀、虚,即湿热瘀血蕴结下焦致肾络损伤、肺脾肾三脏亏虚致下焦摄纳失常。总结出“治血尿六法”,即清咽宁络法,以银翘蒲蓟宁络方治疗血尿伴有扁桃体炎、咽炎;清热利湿法,以双蓟利湿止血方治疗血尿合并泌尿系感染;滋阴清热法,以生地二至止血汤治疗血尿之肾阴亏虚、阴虚火旺证;滋肾益气法,以参芪二至止血汤治疗血尿之气阴两虚证;温补脾肾法,以温阳止血汤治疗血尿之脾肾阴阳俱虚证;化瘀止血法,以茜草逐瘀止血汤治疗顽固性血尿伴有血瘀之象。
This paper summarized the clinical experience of AN Xiaoxian in treating children with renal hematuria from the perspective of heat, dampness, stasis and deficiency. It is believed that the core pathogenesis of children renal hematuria is heat, dampness, stasis, and deficiency, that is, the accumulation of damp heat and blood stasis in the lower
jiao
(焦) causes damage of the kidney collaterals, and the deficiency of lung, spleen, and kidney leads to the lower
jiao
failing to contain and absorb. “Six methods for treating hematuria” is therefore proposed. For hematuria accompanied by tonsillitis and pharyngitis, the method of clearing throat and calming collaterals is used with
Yinqiao Puji Ningluo Formula
(银翘蒲蓟宁络方). For those complicated with urinary tract infection, the method of clearing heat and draining dampness is suggested, and
Shuangji Lishi Zhixue Formula
(双蓟利湿止血方) can be used. Regarding hematuria with kidney
yin
deficiency and
yin
deficiency resulting in vigorous fire, the method of nourishing
yin
and clearing heat should be used with
Shengdi Erzhi Zhixue Decoction
(生地二至止血汤). For those with both deficiency of
qi
and
yin
syndrome, it is recommended to use the method of nourishing kidney and boosting
qi
and take
Shenqi Erzhi Zhixue Decoction
(参芪二至止血汤). The method of warming and supplementing the spleen and kidney is suggested to treat hematuria with spleen-kidney
yin
and
yang
deficiency syndrome using
Wenyang Zhixue Decoction
(温阳止血汤), and the method of dissolving stasis and stanching bleeding can be used to treat intractable hematuria accompanied by signs of blood stasis with
Qiancao Zhuyu Zhixue Decoction
(茜草逐瘀止血汤).
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