朱古亭辨治肾病经验

ZHU Guting’s Experience in Differentiating and Treating Nephropathy

[目的]总结归纳朱古亭教授辨治肾病的经验,完善对其临床思想及医案的研究。[方法]通过对朱古亭教授医学笔记遗稿的整理,归纳其治疗肾病的主要思想,列举分析其治疗肾病证候的3则临床医案。[结果]朱古亭教授对肾病的治疗思想包括对慢性肾炎、肾盂肾炎、尿毒症的认识,认为慢性肾炎病机是机体脏腑阴阳失调及三焦气化功能障碍;肾盂肾炎起于膀胱湿热,久则肾虚,进而累及肝脾;尿毒症病机为脾肾阴阳俱虚或邪毒炽盛。认为慢性肾炎治疗应以温肺健脾、温肾利水为法;肾盂肾炎急性期以清热利湿为主,慢性期以补肾为主;尿毒症需攻补辨证施治。[结论]朱古亭教授对肾病的论治经验,卓有成效,可供临床学习参考。

[Objective]To summarize Professor ZHU Guting’s experience in differentiating and treating nephropathy,and to perfect the study of his clinical thoughts and medical records.[Method]By sorting out ZHU Guting’s medical notes,the main ideas of his treatment of nephropathy were summarized,and the clinical cases of his treatment of nephrotic syndrome were enumerated and analyzed.[Result]ZHU Guting’s treatment of nephropathy includes his understanding of chronic nephritis,pyelonephritis and uremia.He believed that the pathogenesis of chronic nephritis is the disorder of Yin and Yang in the organs and the dysfunction of gasification of the triple energizer.Pyelonephritis begins with bladder dampness and heat.After a period of time,kidney deficiency occurs,which then affects the liver and spleen.The pathogenesis of uremia is deficiency of both Yin and Yang in the spleen and kidney or excessive toxicity.[Conclusion]ZHU Guting believed that the treatment of chronic nephritis should be based on warming the lung,invigorating the spleen,warming the kidney and promoting diuresis;clearing away heat and dampness is the main method in the acute stage of pyelonephritis,tonifying the kidney is the main method in the chronic stage;uremia needs to be treated according to syndrome differentiation.For different types of nephropathy,ZHU Guting listed the prescriptions for the symptoms,which are effective for clinical study.