迟继铭升阳益胃汤联合糖皮质激素治疗脾虚湿盛肾病综合征

CHI Jiming Shengyang Yiwei Soup combined Western Medicine Therapy Followed by Wet Type of Nephrotic Syndrome

迟继铭教授认为脾虚湿盛肾病综合征系脾胃虚弱,升降失司,清气不升,水液代谢失常,发为水肿;强调脾胃同治,善用升阳益胃汤,黄芪30g,人参、甘草-炙各15g,白芍9g,防风、羌活、独活各9g,陈皮6g,茯苓、泽泻、柴胡、白术各5g,黄连1.5g;脾虚明显重用黄芪50g,茯苓30g,泽泻、白术-炒各15g;湿邪重,重用白术-炒、防风、羌活、独活、防风各15g;浮肿重加益母草、冬瓜皮、大腹皮等;伴血尿加仙鹤草、小蓟、茜草、藕节、蒲黄炭等;脾虚兼有气滞,加山楂-焦、砂仁等;腰膝酸痛明显,加仙灵脾、杜仲;血瘀加红花、丹参、葛根等;同时联合糖皮质激素等对症治疗。迟教授强调注重胃气存亡、盛衰,时时顾护胃气。整体调节脏腑功能,调畅气机,控制水肿、蛋白尿,改善临床症状,预防病情复发,疗效确切,体现辨证施治精髓所在。

professor CHI Jiming think pixu（spleen deficient） wet type nephrotic syndrome of spleen and stomach weakness, lifting, loss of water wet spleen, clear spirit not up, do not fall turbid Yin, hair for edema. Late professor emphasizes cure spleen stagnation, Shengyang Yiwei Soup（radix astragali 30 g, ginseng, licorice main each 15 g, radix paeoniae alba 9 g, windproof, notopterygium, live alone every 9 g, 6 g dried tangerine or orange peel, tuckahoe, alisma, radix bupleuri, atractylodes 5 g, 1.5 g coptis; obvious pixu（spleen deficient） reuse of astragalus membranaceus 50 g, 30 g, tuckahoe, alisma, Fried atractylodes each 15 g, the origin, reuse of atractylodes fry, windproof, notopterygium, live alone, wind each 15 g, edema and motherwort, winter melon skin, big belly skin; with hematuria and herba agrimoniae, field thistle, madder, lotus root, cattail pollen carbon, etc.; both pixu（spleen deficient） and qi stagnation, hawthorn coke, amomum villosum, etc.; the waist knee soreness, plus a fairy spleen, eucommia bark, blood stasis and safflower, salvia miltiorrhiza, puerarin, etc.）; Routine for the full amount of glucocorticoid hormones and other symptomatic treatment. The overall regulating zang-fu organs function, adjustable factors, control of edema, proteinuria, improve clinical symptoms, prevention of relapse, curative effect, reflect evidence-based medicine essence.