杨洪涛运用药对治疗血尿经验拾萃

Yang Hong-tao's Experience of Treating Hematuria with Drug Pair

杨洪涛教授秉承《黄帝内经》"少阳属肾,上连于肺,故将两脏"的经典理论,认为少阳枢机功能对于肾之气化,肺之宣肃,以至一身气、火、水的升降出入来说具有重要意义。杨洪涛教授治疗慢性肾脏病宗"肾疏宁疏利少阳"之旨,在小柴胡汤基础上配伍补益脾肾、清热祛痰化瘀中药,取效显著。杨洪涛教授取小蓟、白茅根性凉濡润,入血分而止血之效,凡因热而出现血尿者常用此二药凉血而止血,同时配合地榆、侧柏叶等其他凉血药物,加强柴胡、黄芩疏理中焦热邪之效,临证为防凉血药有凉血留瘀之弊,常采用温性的活血化瘀药蒲黄炭、三七佐之。

Professor Yang Hong-tao inherits the classical theory in Huangdi＇s Canon of Medicine that Shaoyang belongs to the kidney,connects with the lung,so it controls two zang-organs. He thinks that Shaoyang＇s pivot function is important to the kidney＇s gasification,the lung＇s dispersion,ascending and descending of qi,fire and water. So the treatment should disperse the kidney and promote shaoyang. In terms of chronic kidney disease,based on Minor Bupleurum Decoction,TCM for nourishing the spleen and kidney,removing heat and phlegm and blood stasis is often used and has achieved good efficacy. Xiaoji(Herba Cirsii） and Maogen(Rhizoma Imperatae） are cool and moistening in nature,can enter xuefen and stop bleeding,so both are used for hematuria due to heat,at the same time,Diyu(Radix Sanguisorbae） and Cebai(Cacumen Platycladi） and other herbs for cooling blood are combined to increase the function of dispersing heat in middle-jiao of Chaihu(Radix Bupleuri） and Huangqin(Radix Scutellariae）. In order to avoid blood stasis,he often also uses 30 g of Pollen Typhae carbon with warm nature and 6 g of Sanqi(Radix et Rhizoma Notoginseng） for oral administration. He always uses Chaihu(Radix Bupleuri） and Huangqin(Radix Scutellariae） in Minor Bupleurum Decoction,combined with Modified Five Substances Powder with Poria to form Decoction of Radix Bupleuri and Poria to disperse Shaoyang,induce dieresis to alleviate edema,to treat chronic kidney disease with hematuria and swelling and has a remarkable efficacy.