郑健教授分期论治小儿原发性肾病综合征经验

Professor ZHENG Jian’s experience in syndrome differentiation treatment of children with primary nephrotic syndrome by stages

总结了郑健教授采用病证结合、分期论治的临床思维治疗小儿原发性肾病综合征(PNS)的经验。郑教授善于借助西医病名、指标使中医病证诊断更加客观化、标准化,临床中采用辨证选方辅以辨病选药和辨病选方辅以辨证选药2种中医临证思维方式。指出本病以肺脾肾三脏虚弱为本,同时在整个疾病过程中都可出现外感、水湿、湿浊、湿热(湿毒)和血瘀兼夹之证,且肾虚血瘀证常贯穿于疾病的全过程。治疗依据水肿程度、尿蛋白量和激素用量进行分期论治,取得了满意疗效。附案例1则,以资验证。

This paper summarizes professor ZHENG Jian’s experience in taking clinical thinking of combination of disease and syndrome and treatment of children with primary nephrotic syndrome(PNS)based on staging.Professor ZHENG excels at making TCM diagnosis of syndrome more objective and standardized with the help of disease name and index of Western medicine.In clinical practice,he adopts two TCM clinical thinking modes:selecting prescription based on syndrome differentiation accompanied by selecting medicine based on disease differentiation and selecting prescription based on disease differentiation accompanied by selecting medicine based on syndrome differentiation.It is pointed out that PNS is based on the weakness of the lung,spleen and kidney.Meanwhile,the accompanying and concomitant syndromes of external contraction,water-dampness,dampness turbidity,damp-heat(damp toxin)and blood stasis can appear in the whole process of the disease,and the syndrome of kidney deficiency and blood stasis often runs through the whole process of the disease.The treatment is performed by stages according to the degree of edema,the amount of urine protein and dosage of hormone,whereby achieving satisfactory efficacy.One case is attached for verification.