曹式丽从毒论治蛋白尿经验

Cao Shili′s Experience in Treating Proteinuria from Perspective of Toxin

蛋白尿属本虚标实、虚实错杂之证,本虚以肾虚为主,与肺脾肝相关,标实涉及风、湿、热、瘀、浊、毒等。肺脾肾三脏亏虚致三焦不利,水道不通,湿热浊瘀之邪郁而不化,渐变为毒,邪气积于体内,气血津液运行失常,导致脏腑不得濡养,加重脏腑亏虚,毒邪蓄积体内,导致肾体损伤,功能日渐衰退,难以恢复,形成蛋白尿。毒邪生成,肾脏损伤由可逆性变为不可逆性,且毒邪的生成和致病是循序渐进、逐量累积的,贯穿于蛋白尿全程。故在治疗蛋白尿时应注重“解毒”法的应用,需明辨三焦毒邪,随证选药,扶正解毒,标本兼治。肾络细窄,惟虫药之走窜方可直达脏腑,虫药有搜风剔络、解毒散结、益肾固本之功,配伍通络药物以解毒通络,络通则排毒有道,毒邪自解,诸症减轻。

Proteinuria is a combination of deficiency and excess.The former is mainly Kidney deficiency and is related to Lung,Spleen and Liver,and the latter involves Wind,Dampness,Heat,blood stasis,Turbidity,Toxin,etc.The deficiency of the Lung,Spleen and Kidney causes dysfunction the Three Jiao,the blocked waterway.The stagnation of Dampness,Heat and Turbidity and stasis,and they gradually become Toxin.The evil factors accumulate in the body,and the Qi,blood and Fluid run abnormally,resulting in the lack of nourishment of the Zang and Fu,aggravating the deficiency of the Zang and Fu.The accumulation of toxin and evil factor in the body results in the damage of the Kidney body,which leads to the gradual decline of function,the difficulty in recovery,resulting in the formation of proteinuria.The formation of toxins and the formation of Kidney damage from reversible to irreversible,and the generation and pathogenesis of toxins are gradual and cumulative in the whole process of proteinuria.Therefore,in the treatment of proteinuria,we should pay attention to the application of the"detoxification"method,and it is necessary to distinguish the toxin and evil factors in the Three Jiao,to select drugs according to the syndrome,to strengthen the Zheng Qi and detoxify,and treat both the symptoms and the root causes.The Kidney meridian is narrow and only the insect medicine can go directly to the Kidney,since the insect medicine has the function of searching for Wind in the collateral,detoxifying and dispersing knots as well as benefiting the Kidney and consolidating the foundation.The proper compatibility of the drugs to detoxify the collateral,and when the toxin is self-relieved,the symptoms are relieved.