国医大师张大宁教授治疗慢性肾炎经验

The Experience of Master of Traditional Chinese Medicine Zhang Daning in Treating Chronic Glomerulonephritis

目的通过对张大宁教授治疗慢性肾炎的学术思想及临证经验进行总结,概括出慢性肾炎肾虚血瘀的病理实质,以及补肾活血法的临床应用。方法通过长期跟随张大宁教授临证学习,对张大宁教授著作、论文、讲稿的收集整理,以及对其大量慢性肾炎病案的分析总结,对其治疗慢性肾炎的学术思想从病因病机、治疗方法、用药特色等方面进行探讨。结果以基本证型结合辨证论治的独特治疗方法治疗慢性肾炎。在肾虚血瘀基础上,进而对肺肾气虚、脾肾气虚、脾肾阳虚、肝肾阴虚、气阴两虚等证进行治疗,既强调本证的治疗,又强调辨证的灵活应用。结论补肾活血法是慢性肾炎的治疗大法,是在对慢性肾炎肾虚血瘀病理基础高度概括前提下总结提出的。这也是中医学异病同治的具体体现。

Objective On the basis of a systemic summary on Professor Zhang Daning’s academic thought and clinical experience in treating CGN, we summarized the pathological essence of renal deficiency and blood stasis of CGN and the clinical application of tonifying the kidney and activating the blood method. Methods The writer has a long time clinical study with Professor Zhang Daning, and collected and analyzd Zhang Daning’s academic writing, paper and lecture, seek for advice from Zhang Daning ’s clinical cases and at last made reorganization deeply on Zhang Daning’s academic idea in treating CGN. It contained etiology and pathogenesis, therapeutic method and medicine use features. Results Professor Zhang Daning treated CGN with a unique therapeutic method that combined basic syndrome type with syndrome differentiation. On the basis of renal deficiency and blood stasis, Professor Zhang Daning gave treatment to the syndrome of oi deficiency of lung and kidney, oi deficiency of spleen and kidney, yang deficiency of spleen and kidney, yin deficiency of liver and kid-ney, and deficiency of both oi and yin. It not only emphasized the treatment of primary syndrome, but also emphasized the flexible appli-cation of syndrome differentiation. Conclusion The tonifying the kidney and activating the blood method is the main therapeutic method for CGN. It is summarized and put forward in the premise of a high-level overview of the pathological basis of renal deficiency and blood stasis of CGN. It is also the concrete manifestation of same treatment for different diseases in TCM.