乔成林治疗肾小球源性血尿经验

Qiao Chenglin's Experiences in the Treatment of Glomerular Hematuria

肾小球源性血尿为临床肾脏疾病常见症状之一。大多数肾小球源性血尿患者为原发性肾小球疾病,如急慢性肾小球肾炎、IgA肾病等,亦可见于紫癜性肾炎、狼疮性肾炎等继发性肾小球疾病。肾小球源性血尿在临床上,多病情复杂、缠绵难愈,易反复发作。在临床上分为肉眼血尿和镜下血尿两大类,且以镜下血尿较为多见。肾小球性血尿属中医学"尿血"范畴,古籍中有"溲血""溺血"之称,目前西医尚无有效的治疗方法。乔成林老师根据自己多年的临床经验,认为肾小球性血尿病机主要分为虚实两类,实证主要包括下焦湿热证和热入营血证;虚证包括脾肾不固证,阴虚内热证。文章对乔成林教授治疗肾小球源性血尿的经验进行总结,系统阐述了其对肾小球源性血尿中医病因病机的认识、辨病辨证治疗及用药经验。

Glomerular hematuria is one of the common symptoms of kidney disorders in clinic. Most patients of glomerular hematuria suffered from primary glomerular disease,such as acute or chronic glomerulo-nephritis and IgA nephropathy,or secondary glomerular disease such as anaphylactic purpura nephritis and lupus nephritis. In clinic,glomerular hematuria is complicated,difficulty in treatment and repeated attacks. This disease is classified into two categories,named gross hematuria and microscopic hematuria,the latter is common. Glomerular hematuria is in the category of“bloody urine”in traditional Chinese medicine and also named as“Sou Xue”and“Ni Xue”in ancient literatures. At present,there is no any effective therapeutic method in western medicine. According to the clinical experiences of Prof. Qiao Cheng - lin,Prof. Qiao thought that this disease was differentiated as the deficiency and the excess in pathogenesis. The excess syn-drome of it included damp heat in the lower Energizer and heat entering Ying and Xue levels. The deficiency syndrome included the dysfunction of the spleen and kidney and the internal heat of yin deficiency. The paper summarized the experiences of Prof. Qiao Cheng - lin in the treatment of glomerular hematuria and expounded systematically his understandings on the etiology and pathogenesis of this disease,syndrome differentiation, treatment as well as herbal medicine application in terms of traditional Chinese medicine.