吕仁和运用“六对论治”法治疗特发性膜性肾病经验

Experience Introduction of LYU Renhe in Treating Idiopathic Membranous Nephropathy with “Six Ways of Diagnosis and Treatment” Method

国医大师吕仁和教授在长期临床实践中,运用“六对论治”法治疗特发性膜性肾病,针对该病正气亏虚、湿热毒瘀等邪气内着、阻于肾络的核心病机,在扶正祛邪、通络益肾的治疗原则上,依据病理表现进行分期辨证论治。辨证采用极富特色的“本虚定证型、标实辨证候”方法,以气血不足、气阴两伤等本虚证为基础,根据内热、血瘀、湿阻、水停等邪实的变化灵活调整用药,同时注意对症治疗和对症辨证治疗,重视解决激素等西药引起的次生证候,取得了较好的疗效。结合1则医案详析“六对论治”法在特发性膜性肾病中的运用。

In the long-term clinical practice, Prof. LYU Renhe, a master of Chinese medicine,concluded “six ways of diagnosis and treatment”method to treat idiopathic membranous nephropathy. In view of the core pathogenesis of this disease——healthy qi depletion and damp-heat toxin stasis caused by pathogenic qi blocking off kidney collaterals,he treated it with the main principle of reinforcing healthy qi and dispelling pathogen while dredging collaterals and boosting the kidney, and paid much attention on syndrome differentiation according to the pathological stages. He used the unique methods of “determining the syndrome type by deficiency in origin” and “determining the syndrome by excess in superficiality”.When basing on the deficiency of qi and blood and the damage of qi and yin, he flexibly adjusted the medication according to the changes of pathogenic excess,such as internal heat,blood stasis,dampness obstruction,water retention,etc. In addition,he paid attention to specific symptoms and symptomatic differentiation,and emphasized on the solution of the secondary syndromes caused by western medicine like Corticosteroids. In many years of clinical observation, his treatment achieved a good effect. The application of “six ways of diagnosis and treatment”method in treating idiopathic membranous nephropathy was analyzed in detail with one medical case.