基于“伏风理论”探讨IgA肾病的发病与治疗

Exploring the Pathogenesis and Treatment of IgA Nephropathy Based on“Hidden Wind Theory”

IgA肾病是最常见的原发性肾小球肾炎之一,通过系统梳理近年来中医药辨治IgA肾病的理论研究,发现“伏风”的致病特点与IgA肾病的发病机制及临床表现具有相似之处,IgA肾病病机总属本虚标实,肾元亏损是邪气内伏致病的基础。提出“伏风”与IgA肾病发病相关,然后结合疾病的静止期及活动期,分别阐述了邪气可蛰伏于咽喉、肠道、泌尿道,伺机而动,在诱因的作用下,转出少阳三焦,致气化失司。总结历代医家的证治经验,遵循标本兼顾、祛邪务尽的治则,提出了固护脾肾、肃清病灶、托邪外出、搜风通络、疏利三焦等治法。

IgA nephropathy is one of the most common primary glomerulonephritis.By systematically reviewing the theoretical research on the treatment of IgA nephropathy with traditional Chinese medicine(TCM)in recent years,it was found that the pathogenic characteristics of“hidden wind”are similar to the pathogenesis and clinical manifestations of IgA nephropathy.The pathogenesis of IgA nephropathy is generally characterized by root deficiency with superficial excess,with kidney source deficiency as the basis for pathogenesis of hidden pathogenic factors.It is proposed that“hidden wind”is related to the pathogenesis of IgA nephropathy.Furthermore,considering both the quiescent and active phases of the disease,it is explained that pathogenic factors may lurk in the throat,intestines,and urinary tract,waiting for an opportunity to act.Under the influence of predisposing factors,they may then shift to the Shaoyang triple energizers,leading to disorder in qi transformation.Drawing on the clinical experience of past medical practitioners,following the treatment principle of addressing both the root cause and the manifestation,and according to thourouly expelling pathogenic factors,specific therapeutic methods such as fortifying and protecting the spleen and kidneys,clearing the affected area,guiding pathogenic factors outwards,dispersing wind and unblocking the channels,and regulating the triple energizers are proposed.