李建民辨治慢性肾脏病浮阳的经验分析

Experience analysis of LI Jian-min on differentiate floating yang in chronic kidney disease

慢性肾脏病的基本病机是脾肾阳虚,或兼夹湿热、血瘀等标实证,其临床表现除了水肿、乏力、畏寒怕冷、小便清长、夜尿多,大便稀溏等阳虚证症状外,阳虚阴寒内盛,格阳于外,虚阳浮越还会出现口舌生疮、咽痛、头痛、失眠等症状,此类症状在慢性肾脏病的辨证过程中常被忽略或错辨。李建民教授在辨治慢性肾脏病过程中对于浮阳的辨识有着丰富的经验,且其尤其注重临床证候与舌象偶联的辨识,临床收效甚佳。文章从定义、病机、辨证论治、病案举例等方面对其经验进行简要分析,以期对年轻中医师临证有一定指导作用。

The basic pathogenesis of chronic kidney disease is yang deficiency of spleen and kidney, or with some secondary sthenia syndrome like humid heat or blood stasis. Except yang deficiency syndrome like edema, fatigue, cold intolerance, clear urine in large amounts, frequent urination at night, loose stool and so on, there is a series of symptoms because of yang repelled by exuberant yin and deficient yang with upper manifestation, like aphtha, pharyngalgia, headache, insomnia and so on, these symptoms are easy to be ignored and discriminated wrongly. Professor LI Jian-min has rich experience which are effective in differentiating floating yang across the course of chronic kidney disease, and during the process he values the connection of clinical syndrome and tongue picture. This paper summarized his experience briefly from the definition, pathogenesis, diagnosis and treatment, case record and so on of floating yang. The aim of this paper is to provide guidance for the young traditional Chinese doctors.