1.天津中医药大学第一附属医院,天津市西青区昌凌路88号,300381
2.国家中医针灸临床医学研究中心
wangyaoguang1012@126.com
收稿:2023-01-28,
修回:2023-05-09,
纸质出版:2023-08-17
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赵晰,祝昌昊,王耀光.基于温肾化气法论治膜性肾病[J].中医杂志,2023,64(16):1707-1710.
ZHAO Xi,ZHU Changhao,WANG Yaoguang.Treatment of Membranous Nephropathy based on the Method of Warming the Kidney and Transforming Qi[J].Journal of Traditional Chinese Medicine,2023,64(16):1707-1710.
赵晰,祝昌昊,王耀光.基于温肾化气法论治膜性肾病[J].中医杂志,2023,64(16):1707-1710. DOI: 10.13288/j.11-2166/r.2023.16.015.
ZHAO Xi,ZHU Changhao,WANG Yaoguang.Treatment of Membranous Nephropathy based on the Method of Warming the Kidney and Transforming Qi[J].Journal of Traditional Chinese Medicine,2023,64(16):1707-1710. DOI: 10.13288/j.11-2166/r.2023.16.015.
认为膜性肾病的基本病机为脾肾亏虚,肾失气化与膜性肾病的发生和发展密切相关,脏腑气化失司、精微失摄下泄、水瘀浊毒内留是其核心病机,发病过程中正虚、邪实之间相互影响,互为因果,终成虚实夹杂之证。根据膜性肾病临床特点,治疗采用温肾益气、扶正培元法,常用自拟方膜肾1号方;温肾藏精、固摄精微法,常用水陆二仙丹、金锁固精丸、桑螵蛸散等;温肾利水、通利三焦法,常用防己黄芪汤合五苓散加减;温肾活血、消瘀除癥法,常用桃红四物汤、当归芍药散及虫类药等;温肾泄浊、推陈致新法,常用茵陈失笑散合温脾汤加减。
It is believed that the basic pathogenesis of membranous nephropathy is spleen and kidney depletion, and the loss of
qi
transformation in the kidney is closely related to the occurrence and development of membranous nephropathy. The core pathogenesis of membranous nephropathy is
qi
transformation failure of
zang
-
fu
(脏腑) organs, the essence and the mild discharge, water stasis and turbidity toxin retention. During the progression of the disease, healthy
qi
deficiency and pathogenic
qi
excess influence each other and interact as both cause and effect, finally forming into the syndrome of deficiency and excess complex. According to the clinical characteristics of membranous nephropathy, different treatment methods are used, by warming the kidney and boosting
qi
, reinforcing healthy
qi
and cultivating the vital energy usually with self-made
Moshen No.1 Formula
(膜肾1号方), by warming the kidney to store the essence and consolidate the essence with
Shuilu Erxian Elixir
(水陆二仙丹),
Jinsuo Gujing Pill
(金锁固精丸) and
Sangpiaoxiao Powder
(桑螵蛸散), by warming the kidney to promote urination and unblock the three
jiao
(焦) with
Modified Fangji Huangqi Decoction and Wuling Powder
(防己黄芪汤合五苓散加减), by warming the kidney to invigorate the blood, dispersing stasis and eliminating corrections with
Taohong Siwu Decoction
(桃红四物汤),
Danghui Shaoyao Powder
(当归芍药散) and insect medicinals, by warming the kidney to drain turbidity and pushing out the old to bring in the new with
Modified Yinchen Shixiao Powder and Wenpi Decoction
(茵陈失笑散合温脾汤加减).
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