从风论治慢性肾小球肾炎研究进展

Research Progress of Chronic Glomerulonephritis Treatment from Perspective of TCM Wind Evil

慢性肾小球肾炎(简称慢性肾炎)属于中医学"肾风""风水"等范畴,肾脏本虚、风邪侵袭的致病机理自古即有论述,且得到现代医家的广泛认可,经典方剂、经验方剂、单药的临床应用与实验研究均取得一定进展,但就目前的研究现状而言亦存在某些不足。(1)从风论治慢性肾炎的疗效虽得到了验证,但缺乏多中心、大样本的临床研究;(2)祛风类单药对于慢性肾炎的治疗效果显著,但目前数量较少,需要进一步挖掘;(3)多数医家从风论治而强于祛风次于补肾,忽略肾脏本虚是风邪袭肾的前提;(4)风邪致病据其临床表现有风寒、风湿、风热等区分,但目前缺乏统一的证候分型,各医家多根据个人经验处方用药,不利于专方专药的确立。根据以上几点不足,在后续的研究中应重视多中心、大样本的临床研究;着重挖掘治疗慢性肾炎有效的祛风类单药,规避复方汤药在剂型、口感等方面的不足;治疗时祛风与补肾同时兼顾,标本同治;根据风邪致病的临床表现,确立统一的证候分型,以便于专方专药的开发与确立。由于风邪贯穿于慢性肾炎的始终,故从风论治在慢性肾炎迁延不愈的过程中地位重要,单药的挖掘将会拓宽慢性肾炎的治疗途径,大样本的临床研究及专方专药的确立将会使从风论治慢性肾炎更加科学化与规范化。

Chronic Glomerulonephritis belongs to the traditional Chinese medicine the diseases of＂Kidney Wind＂and＂Wind Water＂.The pathogenesis such as Kidney deficiency and Wind Evil invasion was found since ancient times and has been widely recognized by modern doctors.In treatment of the disease,classic prescriptions,experimental prescriptions as well as single flavor drug clinical application and research have made some progress.However,the current research situation still has some shortcomings.（1）the efficacy of the treatment of chronic nephritis in Perspective of TCM Wind Evil has been verified,but there is a lack of multicenter,large sample of clinical research;（2）The curative effect of single flavor drugs in chronic nephritis treatment is significant,but the current number of them is still small,which need further excavating.（3）The majority of doctors pay more attention in dispelling Wind than in tonifying Kidney.However,the latter actually is the basis of the former.（4）Wind induced diseases according to its clinical manifestations can be classified into Cold Wind,Dampness Wind,Heat Wind,but there is a lack of standard syndromes classification.Doctors prescribe medication mainly based on personal experience,which is not conducive to the establishment of the drug standardization.In order to avoid the above shortcomings,future studies should pay much attention to multi-center,large sample of clinical researches and to find out effective single flavor drugs which can dispel Wind evil in treatment of chronic nephritis in order to avoid the displeasing taste and in convenient dosage of the compound decoctions.At the same time dispelling Wind and tonifying Kidney should be taking into account in treatment of the disease.According to the clinical manifestations of the disease,a unified syndrome classification should be established in order to facilitate the development and establishment of the creation of special drugs.As the Wind Evil exists throughout the duration of chronic nephritis,in the process of treatment dispelling Wind is always important by using a large sample of clinical researches and special medicines since the therapy is more scientific and standard.