摘要
IgA肾病(IgAN)是一种以肾小球系膜区大量IgA及免疫复合物沉积为特征的原发性肾小球疾病。巴元明教授认为IgAN的基本病机为肾水不足,肾燥失濡。阴液不足,燥热内生为发病之本,风热扰肾、热灼血络、精微下泄、浊毒内伏为发病之标。根据IgAN病因病机及发病特点,巴元明教授基于“肾苦燥”辨治IgAN,以滋肾润燥诸法治之。针对气阴两虚证,滋肾益气,以润为补,方选参芪地黄汤、三才封髓丹;风热扰肾证,滋肾祛风,透邪通络,方选升降散加减;阴虚血热证,滋肾清热,凉血宁络,方选自拟滋肾凉血汤;肾精不固证,滋肾封藏,固摄精微,方选金锁固精丸、水陆二仙丹;阴虚浊毒证,滋肾泻浊,推陈致新,方选自拟精天承气汤。
IgA nephropathy(IgAN)is a primary glomerular disease characterized by the deposition of large amounts of IgA and immune complexes in the mesangial area of renal glomeruli.Professor Ba Yuanming believes that the basic pathogenesis of IgA nephropathy is insufficient kidney water and kidney dryness.Insufficient yin fluid and internal generation of dry heat are the root cause of the disease,while kidney disturbance by wind-heat,heat scorching blood collateral vessels,leakage of essence,and accumulation of turbid toxins are the superficial cause of the disease.Considering the etiology,pathogenesis,and characteristics of IgA nephropathy,we should focus on nourishing the kidneys and moisturizing dryness for the treatment based on the idea of“kidney insufficiency manifesting as dryness”.If the patient has deficiency of both qi and yin,the kidney should be nourished and replenish qi should be replenished with moistening medicinals,with enriching medicinals as medication,and Shenqi Dihuang decoction and Sancai Fensui Dan as treatment formulae;if the patient has the syndrome of wind-heat disturbing the kidney,enriching the kidney and dispelling wind,and opening the collaterals to expel pathogenic factors should be taken as treatment approach,and modified Shengjiang San can be taken as treatment formula;if the patient suffers from the syndrome of yin deficiency with blood heat,we should treat the patient with the method of enriching the kidney and clearing heat,and cooling blood to calm the collaterals,and the we can use the formula of Xijiao Dihuang decoction;if the patient has the syndrome of kidney essence insecurity,enriching the kidney to secure and store essence can be applied,with Jinsuo Gujing pill and Shuili Erxian Dan for the treatment;if the patient has the syndrome of yin deficiency with turbid toxins,the method of enriching the kidney to discharge turbidity,removing stagnation to induce newness can be employed,with the a self-made Jingtian Chengqi decoction for the treatment.
作者
刘馥溧
巴元明
LIU Fuli;BA Yuanming(Hubei University of Chinese Medicine,Wuhan 430061,China;Affiliated Hospital of Hubei University of Chinese Medicine,Wuhan 430061,China)
出处
《中医药学报》
CAS
2024年第12期56-58,共3页
Acta Chinese Medicine and Pharmacology
基金
2022年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)
第六批全国老中医药专家学术经验继承工作指导老师项目(国中医药人教发﹝2017﹞29号)。
关键词
IGA肾病
肾苦燥
滋肾润燥
中医药
IgA nephropathy
Kidney insufficiency manifesting as dryness
Enriching the kidney and moisturizing dryness
Traditional Chinese Medicine
