五苓散治疗IgA肾病理论探讨

Discussion on the Treatment of IgA Nephropathy with Wuling Powder

IgA肾病属本虚标实,本虚多为阴虚、气虚或气阴两虚,其中又以气阴两虚为主;标实是水湿与瘀血互结。临床上主要表现以肉眼或显微镜下血尿、血尿伴蛋白尿、水肿和高血压为主,最后进展为肾功能衰竭,是导致终末期肾病(ESRD)的重要病因。但国内报道IgA肾病表现肾病综合征者明显高于国外报道,约为10%～20%,大量蛋白尿和水肿为主要表现。近现代医家及临床学者应用五苓散加减化裁治疗IgA肾病报道较少,现将五苓散加减化裁治疗IgA肾病理论作以探讨。

IgA nephropathy belongs to deficiency and excess,most of the deficiencies are Yin deficiency, Qi deficiency or Qi-Yin deficiency, among which Qi-Yin deficiency is the main one;The excess is the combination of water and dampness and blood stasis. The main clinical manifestations are hematuria under naked eye or microscope,hematuria with proteinuria,edema and hypertension,and finally progression to renal failure,which is an important cause of end-stage nephropathy(ESRD). However,the number of IgA nephropathy with nephrotic syndrome in China was significantly higher than that in foreign countries,about 10%-20%,with large proteinuria and edema as the main manifestations. There are few reports on the treatment of IgA nephropathy by Wuling Powder plus or subtractive cutting,so the theory of Wuling Powder in the treatment of IgA nephropathy is discussed in this paper.