名老中医杨霓芝治疗慢性肾小球肾炎经验

Yang Nizhi′s Experience on Treating Chronic Nephritis

慢性肾小球肾炎(简称慢性肾炎)是由多种不同病因、不同病理类型组成的一组原发性肾小球疾病,临床特点为病程缠绵难愈,易反复发作,伴有不同程度的水肿、蛋白尿、血尿,可伴高血压和(或)氮质血症,及进行性加重的肾功能损害。文章从病因病机认识、经验归纳、验案分析等方面系统阐述杨霓芝教授辨治慢性肾炎的学术思想与临证经验。杨霓芝教授认为慢性肾炎属于中医“水肿”“尿浊”等范畴,慢性肾炎多为本虚标实之证,本虚为脏腑虚损,标实是由于脏腑虚损,导致气化功能障碍,湿浊毒邪滞留为害,或者外邪侵袭人体发病,其中以水湿、湿热、瘀血为多。其临床治疗注重辨病辨证相结合、邪正相顾、中西结合,其基于“气虚血瘀”理论治疗慢性肾炎在临床上具有显著疗效,可有效延缓疾病进展,改善患者生存质量。作者根据其临床常见方药总结出治疗慢性肾炎的基本方及其加减运用,以期为临床工作者提供辨证施治经验和思路。

Chronic nephritis is a group of primary glomerular diseases composed of a variety of different etiologies and pathological types.Its clinical characteristics are lingering and difficult to heal,easy to relapse,accompanied by varying degrees of edema,proteinuria,hematuria,hypertension and/or azotemia,and progressive renal function damage.This paper systematically expounds Professor YANG Nizhi′s academic thought and clinical experience in the treatment of chronic nephritis from the aspects of etiology and pathogenesis,experience induction and case analysis.Professor YANG Nizhi believes that chronic nephritis belongs to the categories of“edema”and“urine turbidity”in traditional Chinese medicine.Most of chronic nephritis is the syndrome of deficiency and excess,which is the deficiency and loss of Zang-Fu organs.The deficiency and excess is due to the deficiency and loss of Zang-Fu organs,resulting in Qi movement dysfunction,retention of dampness,turbidity and toxic pathogens,or external pathogens invading the human body,most of which are water-dampness,dampness-heat and blood stasis.Its clinical treatment focuses on the combination of disease differentiation and syndrome differentiation,the combination of evil and vital Qi,and the combination of traditional Chinese and Western medicine.Its treatment of chronic nephritis based on the theory of“Qi deficiency and blood stasis”has a significant clinical effect,which can effectively delay the progress of the disease and improve the quality of life of patients.According to its common clinical prescriptions,the author summarizes the basic prescriptions and their modified formulae in the treatment of chronic nephritis,in order to provide the experience and ideas of syndrome differentiation and treatment.