占永立教授益气温阳、活血利水法治疗特发性膜性肾病的经验

Experience of Professor ZHAN Yongli in the Treatment of Idiopathic Membranous Nephropathy by the Methods of Supplementing Qi for Warming Yang and Activating Blood for Diuresis

占永立教授认为特发性膜性肾病的中医病机以肺脾肾亏虚为本,血瘀、水停为标,确立了以益气温阳、活血利水法治疗特发性膜性肾病的基本思路,主要分为三型论治:肺气亏虚,血瘀水停证,治宜益肺固表,活血利水,方以防己黄芪汤合当归芍药散加减;脾阳不足,血瘀水停者,宜健脾温阳,活血利水,方以实脾饮合补阳还五汤加减;肾阳虚衰,血瘀水停,当温肾助阳,活血利水,方以真武汤合桃红四物汤加减。

According to the pathogenesis characteristics of idiopathic membranous nephropathy(IMN),which lied in deficiency of lung,spleen and kidney as the root,and blood stasis and water retention as the branch,professor ZHAN Yongli established the basic treating ideas by supplementing qi for warming yang and activating blood circulation for promoting diuresis,which can be divided into the following 3 types:for patients with deficiency of lung qi,and blood stasis and water retention syndrome,the suitable treatment should be benefiting lung to consolidate superficies,promoting the circulation of blood and increasing water excretion,and the combination prescription of Fangji Huangqi Decoction and Danggui Shaoyao Powder can be used;as for deficiency of spleen yang,and blood stasis and water retention syndrome,treatment of strengthening spleen to warm spleen yang,and promoting the circulation of blood and increasing water excretion can be used.The suitable prescription can be the combination of modified Shipi Drink and Buyang Huanwu Decoction;the combination of Zhenwu Decoction and Taohong Siwu Decoction can be used for patients with kidney yang deficiency,and blood stasis and water retention syndrome in order to warm kidney and tonify kidney Yang.