难治性原发性肾病综合征的病机探析及中西医结合治疗概况

The Pathogenesis of Refractory Primary Nephritic Syndrome and Current Therapy by Integrated Chinese and Western Medicine

难治性肾病综合征(RNS)的难治性关键在于其病程较长、病情复杂、病理多变、病邪缠绵、难于祛除。目前多采用中西医结合治疗,配合中医药应用的方法主要有:(1)辨证治疗,谨守脾肾亏虚、实邪交困机理辨证施治。(2)分期而治,在免疫抑制剂使用疗程中各个阶段出现不同的副反应而采取针对性治疗。(3)经验组方,发挥自身有效治疗经验特长。(4)病证结合,依据先进医学检测手段融贯中西理论治疗。综合报道表明中西医结合治疗RNS可以获得比单纯应用西药治疗更好的疗效,减少复发,减少副作用。但仍需大规模多中心的前瞻性临床研究证实结论、进一步多方面的实验研究阐明机理。

The refractory nephritic syndrome（RNS） has poor prognosis for the following factors：long illness course,complicated conditions,variable pathologic presentation and hard-to-removing etiological factors.The current treatment mainly depends on the integrated Chinese and western medicine.The traditional Chinese medicine concludes four therapeutic methods.Firstly,the differential treatment focuses on deficiency of spleen and kidney together with stasis of wet.Secondly,the stage treatment deals with the side effect of immunosuppressive therapy.Thirdly,the empirical prescription has special effect for specific cases.Fourthly,the combination of disease and syndrome provides the convergence of Chinese and western medicine theory.Literatures reported the better results,less recurrence and side effect from therapy by integrated Chinese and western medicine other than just by western medicine.However the multi-centered prospective clinical study is needed to prove the results.Furthermore,the basic research is needed to illustrate the mechanism.