潘月丽运用“肝肾大肠同调”法治疗儿童紫癜性肾炎经验

PAN Yueli’s Experience in Treatment of Purpura Nephritis in children with“Harmonizing Liver,Kidney,and Large Intestine”Method

潘月丽教授认为儿童紫癜性肾炎的病机总归气虚、血瘀、湿热,其产生与肝、肾、大肠密切相关,故提出“肝肾大肠同调”的治疗理念,认为“补气更需补肾,活血不离疏肝,清利湿热宜通肠腑”。补肾常选金匮肾气丸加减,或在他方基础上加用菟丝子、淫羊藿、肉苁蓉等补肾之品;活血常选血府逐瘀汤或桃核承气汤加减,善用青皮、香附、佛手等疏肝行气之品;清热利湿常用润下药物,以通利肠腑,给邪气以出路。附验案1则。

Professor PAN Yueli believes that the pathogenesis of purpura nephritis in children is ultimately related to qi deficiency,blood stasis,and dampness-heat,which is closely related to the liver,kidney,and large intestine.Therefore,she puts forward the therapeutic concept of“harmonizing the liver,kidney and large intestine”,stating that“supplementing qi requires supplementing the kidney,promoting blood circulation cannot be separated from soothing the liver,and clearing dampness-heat should focus on promoting bowel movements”.When tonifying the kidney,Jingui Shenqi Pill(金匮肾气丸)is often chosen as the main prescription with modifications.Alternatively,other kidney-tonifying medicinals such as Tusizi(Cuscutae Semen),Yinyanghuo(Epimedii Folium),and Roucongrong(Cistanches Herba)can be added to other formulas.When promoting blood circu-lation,Xuefu Zhuyu Decoction(血府逐瘀汤)or Taohe Chengqi Decoction(桃核承气汤)with modifications are often chosen,and it is also beneficial to use Qingpi(Citri Reticulatae Pericarpium Viride),Xiangfu(Cyperi Rhizoma),and Foshou(Citri Sarcodactylis Fructus)to soothe the liver and promote qi flow.When clearing heat and removing dampness,moistening and purging medicinals are often used to promote bowel movement and facilitate the expulsion of pathogenic factors.One proved case is attached.