曹式丽教授从脾胃论治膜性肾病经验

Professor Cao Shili's experience in the treatment of membranous nephropathy from the perspective of the spleen and stomach

总结曹式丽教授从脾胃论治膜性肾病一体化临证经验。膜性肾病是成年人肾病综合征的主要病因之一,近年来发病率明显升高。全国老中医药专家学术经验继承工作指导老师、天津市名中医曹式丽教授重视脾胃调节膜性肾病免疫发病机制,针对低蛋白血症治疗一方面以泻心汤类辛开苦降恢复脾主升清及胃主降浊之功能畅达气机,以香砂养胃丸和/或健脾丸配伍黄芪、党参及甘草等顾护脾胃元气;另一方面以升阳益胃汤合祛风胜湿类中药提升脾胃清阳,调理胃纳脾运功能以增进食纳利消化。针对蛋白尿治疗提出脾肺同治重卫气及脾肾同治重固摄的治疗方法。随着改善胃肠功能障碍纠正低蛋白血症,蛋白尿、凝血等也会随之好转。综上,从新的角度治疗膜性肾病,临证验方随症加减,生活质量明显改善。

This paper means to summarize Professor Cao Shili's clinical experience in the treatment of membranous nephropathy from the perspective of the spleen and stomach.The disease is one of the main causes of nephrotic syndrome in adults,and its incidence has increased significantly in recent years.Professor Cao Shili pays attention to the spleen and stomach regulating the immune pathogenesis of membranous nephropathy.For the treatment of hypoproteinemia,on the one hand,Xiexin decoction is used to restore the function of the spleen and stomach to promote qi circulation,and Xiangsha Yangwei pill and/or Jianpi pill combined with milkvetch root,tangshen,and liquorice root is/are used to strengthen the primordial qi of the spleen and stomach.On the other hand,Shengyang Yiwei decoction combined with herbs,which have the effects of dispelling wind and eliminating dampness,is used to enhance clear yang of the spleen and stomach,to regulate the functions of the stomach and spleen to promote food digestion.For the treatment of proteinuria,he proposes the method that the spleen and lung are treated together to enhance defensive qi,and the spleen and kidney are treated together to invigorate the kidney qi.With the improvement of gastrointestinal dysfunction and hypoproteinemia,the symptoms such as proteinuria and coagulation,etc.,will also improve.In conclusion,membranous nephropathy can be treated from a new perspective,with the experiential effective formula modified according to clinical symptoms,and the quality of life significantly improved in patients.