38年中西医结合治疗肾脏病的临床和实验研究

The Clinic and Experimental Researches on Treatment of Nephritic Diseases with the Integrating Traditional Chinese Medicine and Western Medicine for 38 Years

报告作者 38年来中西医结合治疗肾脏病的临床和实验研究的成果。临床研究包括 :①在国内率先提出先辨病后辨证的中西医结合诊断模式及慢性肾炎新的中医辨证分型标准 ,并对其证候实质进行了初步的探索 ;②针对肾小球疾病肾上腺皮质激素用药规律及其对中医证候变化的影响 ,首创根据激素不同用药阶段进行中西医结合的治疗方案 ,行之有效 ;③辨病组方 ,辨证施治 ,创立了独具特色的狼疮性肾炎的中西医结合治疗详尽方案 ;④发挥中医药优势 ,根据慢性肾功能衰竭不同阶段特点辨证用药 ,有效地改善症状和延缓病变进展 ;⑤对慢性肾小球肾炎、泌尿系结石、非感染性尿路综合征等西医难治病 ,用中西医结合治疗 ,取得较满意疗效 ;⑥对腹膜透析患者 ,首创了中西医结合疗法 ,并获得较高评价 ;⑦将治疗慢性肾炎的经验方“肾炎合剂”成功地转化成产品 ,商品名“慢肾宝” ,获得较好的社会效益和经济效益。实验研究主要对丹参、全蝎、三七总甙、大黄素、桃红四物汤进行了研究 ,结果显示 :丹参、三七总甙、大黄素对狼疮性肾炎患者肾成纤维细胞增殖有抑制作用 ,并通过使c myc蛋白高水平表达而诱导细胞凋亡。全蝎可减少大鼠膜性肾炎蛋白尿 ,抑制白介素 1活性 ,并扩张肾毛细血管 ,抑制血栓形成及炎症细胞因子释放 ,从而影响肾炎?

Study on treatment of nephritic diseases with methods integrating traditional Chinese medicine (TCM) and western medicine during past 38 years are briefly reviewed. The clinic studies included: ① We advanced firstly in China the diagnosis model with the method integrating TCM and western medicine(WM) that TCM differentiation of symptom-complexes should be performed after disease diagnosis is established. Also we proposed new standard on TCM differentiation of symptom-complexes in chronic nephritis. The material bases of TCM symptom-complexes had been explored primarily. ② Aimed at the treatment program of prednison and its effect on TCM symptom-complexes in chronic nephritis, we created firstly the effective treatment scheme with integrating TCM and WM according different stages of treatment program of prednisone. ③ Characteristic detailed treatment program of lupus nephritis by integrating TCM and WM had been established. ④ Giving full play to TCM superiority, by diagnosis and treatment based on an overall analysis of symptoms and signs in different stages of chronic renal failure, the symptom of the disease had been effectively relived and the progression of the renal function deterioration had been retarded. ⑤ Using the method of integrating TCM and WM, there were well curative effects on chronic glomerulonephritis, nephrolithiasis and non-infection urinary tract symptom on which there are not effectively treating methods by using western medicine. ⑥ We had gotten a rather high opinion of the methods integrating TCM and WM on treatment of peritoneal dialysis patients. ⑦ We had received good social and economic benefits by transforming the recipe which we created to treat chronic glomerulonephritis effectively into merchandise named “Manshenbao”. The experimental studies showed: ① Radix Salivae Miltiorrhizae, Panax Notoginseng Saponins, and Emodin obviously promoted the apoptosis of renal interstitial fibroblasts from patients of lupus nephritis resulting inhibition of cell proliferation by upregulating of c-myc protein and may be effective drugs for renal interstitial fibrosis. ② Scorpion decreased urinary protein and relived the renal pathologic changes dramatically in rat membranous nephropathy model by inhibiting the activity of Interleurin-1, release of inflammation factors and formation of thrombolia and by dilating capillary blood. ③ Taohong Siwu Docoction obviously reduced platelet activating factor(PAF), thromboxane B 2 (TXB 2) in renal cortex and it is effective for the treatment of rat anti-glomerular basal member(GBM) glomerulonephritis.