基于玄府理论探讨风药治疗蛋白尿的内涵

On wind-herb therapies for proteinuria based on the xuanfu theory

蛋白尿是肾脏疾病的常见临床表现,西医对蛋白尿的治疗以控制原发病为主,中医药在减轻或消除蛋白尿方面优势明显,且风药的运用独树一帜,但目前中医界对治疗蛋白尿的探讨多局限于单一疾病。玄府理论体现了中医学的微观视角,肾小球滤过膜、肾小管与玄府有共通之处,可视为肾之玄府之一。风邪侵袭是肾性蛋白尿的诱因,即风性开泄,循经入肾,使肾失封藏,精微外泄。玄府理论可为风邪诱发肾性蛋白尿的病理过程提供中医学微观视角。开玄启闭,需用风药,风药身兼数用,可开玄利水、畅玄活血,需寒温相伍、开补并施。

Proteinuria,a common clinical manifestation of kidney diseases,is primarily managed in Western medicine by controlling the underlying condition.Traditional Chinese Medicine(TCM) offers distinct advantages in alleviating or eliminating proteinuria,with wind-herb therapies presenting a unique approach.However,current discussions within the TCM community regarding proteinuria treatment often focus on individual diseases,limiting broader perspectives.The xuanfu(sweat pore) theory,representing a microscopic view in TCM,parallels the glomerular filtration membrane and renal tubules with the concept of xuanfu,which can be seen as xuanfu of the kidney.Wind evil invasion is identified as a trigger for proteinuria,disrupting the kidney's ability to retain essential substances,resulting in their leakage.The xuanfu theory offers a microscopic understanding of the pathological process underlying renal proteinuria induced by wind evils.To open the obstructed xuanfu,wind herbs are needed for their multifaceted properties of promoting fluid regulation and blood circulation.Additionally,a balanced integration of cold and warm herbs,as well as simultaneous use of tonifying and unblocking herbs,may be necessary for effective management.