肾移植术后患者肺部感染临床特点及中医辨证治疗

Pulmonary Infection after Kidney Transplantation:Clinical Traits and TCM Treatment by Differentiaion of Symptoms and Signs

目的探讨肾移植术后肺部感染患者的临床特点、发病机制和中医分段辨证治疗。方法根据肾移植术后患者易并发肺部感染且有症状不典型、起病隐匿及感染呈多样性等特点,阐明了该病的发病机制是以正虚(肾虚)为本,以感邪(热、毒、瘀蕴结于肺)为标,即正虚邪实,故在治疗上应重视调理整体功能状况,采用急性期和恢复期2个阶段分别施以清热、解毒、活血,补肾养阴、清热润肺等辨证治疗,标本兼顾。结果中医药治疗肾移植术后肺部感染采用分期论治,具有疗效高、不良反应少、远期疗效稳定的特点。结论中医药治疗肾移植术后肺部感染具有较大的潜力和优势,值得进一步研究。

OBJECTIVE To discuss the clinical traits, pathogenesis and traditional Chinese medicine （TCM） stepwise treatments of the patients who suffered from pulmonary infection after kidney transplantation. METHODS Because of patients after kidney transplantation easily suffered from pulmonary infection, which was characterized by non-typical symptoms, concealment and varity. In the aspects of the pathogenesis of this disease, the principal aspect of which was the weakened body resistance（kidney deficiency）and the secondary incidental was affected pathogenic factor （heat, toxin, stasis brewing in the lungs）, viz weaken healthy qi and excessive pathogenic factor. Hence during the clinical treatment we should attach importance to regulate entire faculty condition. Considering the acute attack stage and restoration stage, we would differently inflict therapies of clearing heat,resolving toxin, quickening the blood, supplementing the kidney and nourishing yin, clearing heat and moistening the lung and so on, according to differentiation of symptoms and signs,in which way we could give attention to both the root and tip. RESULTS The TCM stepwise therapy of pulmonary infection after kidney transplantation had the characteristics of high efficacy, few side reactions and stable long-term curative effects. CONCLUSIONS The TCM therapy of pulmonary infection after kidney transplantation has more potentiality and predominance, which deserves further study.