张勉之教授基于“肾虚血瘀”理论治疗蛋白尿的临证经验

Professor Zhang Mianzhi’s clinical experience in treating proteinuria based on the theory of“kidney deficiency and blood stasis”

蛋白尿作为慢性肾脏病常见的临床表现之一,中医药治疗蛋白尿可避免西医治疗方案所带来的毒副作用大、疗效不明确等问题。基于此张勉之教授以“肾虚血瘀”理论来治疗蛋白尿,张勉之教授认为蛋白尿的病因病机主要归为“肾虚血瘀”,同时脾虚、湿浊、风邪、热毒也是导致病情发生、发展的关键因素。因此其主张将“补肾活血”这一治疗法则贯穿于疾病的治疗全过程中,并取得了显著的治疗效果。本文以“肾虚血瘀”理论阐释张勉之教授治疗蛋白尿的临证经验,并附1则案例,以供讨论。

Proteinuria as one of the common clinical manifestations of chronic kidney disease,Chinese medicine treatment of proteinuria can avoid the western medicine treatment brought by the toxic side effects,unclear curative effect,and other problems.Based on this,Professor Zhang Mianzhi uses the theory of“kidney deficiency and blood stasis”to treat proteinuria.Professor Zhang Mianzhi believes that the etiology and pathogenesis of proteinuria are mainly classified as“kidney deficiency and blood stasis”,and spleen deficiency,dampness turbidity,wind evil,and heat toxicity are also key factors leading to the occurrence and development of the disease.Therefore,he advocates that the therapeutic principle of“tonifying kidney and promoting blood circulation”should be carried out in the whole process of disease treatment,and remarkable therapeutic effects have been achieved.Based on the theory of“kidney deficiency and blood stasis”,this article explains the clinical experience of Professor Mianzhi in the treatment of proteinuria,and provides a case for discussion.