1.北京中医药大学 北京 100029
2.首都医科大学附属北京中医医院
3.长春中医药大学
周小姗,女,在读硕士生
# 刘宝利,男,博士,主任医师,博士生导师,E-mail: liubaoli@bjzhongyi.com
纸质出版日期:2023-09-30,
收稿日期:2022-12-10,
移动端阅览
周小姗, 郑洋, 芮宏亮, 等. 基于内经开阖枢理论从太阴机转认识原发性膜性肾病[J]. 现代中医临床, 2023,30(5):59-63.
ZHOU Xiaoshan, ZHENG Yang, RUI Hongliang, et al. Exploration the
周小姗, 郑洋, 芮宏亮, 等. 基于内经开阖枢理论从太阴机转认识原发性膜性肾病[J]. 现代中医临床, 2023,30(5):59-63. DOI: 10.3969/j.issn.2095-6606.2023.05.011.
ZHOU Xiaoshan, ZHENG Yang, RUI Hongliang, et al. Exploration the
原发性膜性肾病作为成人肾病综合征的主要病因,以水肿为首发表现,在发病初期和迁延不愈阶段均兼有腹胀、便溏等症状。基于临床经验,发现太阴之本虚存在于部分发病人群,外来风邪易侵扰少阴表位,且易入里损及三阴。基于此,水肿发于少阴之表位,病程初期,病机单一,病邪易入里;若病邪拘于太阴,气血郁遏,则病程中后期,病机复杂,由此产生一系列并发症。又可复损及少阴,从而复发;或进一步传至厥阴,进入肾病终末期。结合病邪反应在机体的发病部位,根据六经八纲辨证,该病属少阴太阴合病;基于三阴开阖枢理论,总结原发性膜性肾病病机传化特点当以太阴为本、少阴为始、厥阴为传。并以“太阴本虚”的概念指导治肺脾而治肾的思路,以驱邪外出兼以温里为总则,临床以甘姜苓术汤治疗原发性膜性肾病太阴里虚寒证候,随证化裁,效果良好。
Primary membranous nephropathy (PMN) is the main cause of adult nephrotic syndrome
with edema as the first manifestation. Abdominal distension
loose stool and other symptoms can be observed in the early and prolonged stages of the disease. Based on clinical experience
it was found that the deficiency of
taiyin
may exist in some patients
so that external wind evil may easily attack the exterior
shaoyin
and further damage the three yin. Therefore
edema occurs in exterior
shaoyin
. A single pathogenesis is in play at the early stage
yet it is still easy for pathogens to enter the inside. If the evil is confined to
taiyin
with qi and blood repressed
the pathogenesis will be complex in the middle and late stages of the disease. Resulting in a series of complications. Then
shaoyin
can be damaged again
causing relapses. The evil may even further spread to
jueyin
leading to the end stage of nephropathy. According to the syndrome differentiation of the six meridians and eight principles
this disease belongs to the combination of
shaoyin
and
taiyin
. Based on the theory of "opening
closing
and pivoting" of the three
yin
the pathogenesis of PMN should be studied with
taiyin
as the base
shaoyin
as the beginning and
jueyin
as the transmission. The idea of treating the kidney by treating the lung and spleen is guided by the concept of "deficiency of
taiyin
" . The main principle is to expel evil and warm the interior. In clinical pracice
Ganjiang Lingzhu Decoction is used to treat the deficiency and cold syndrome of
taiyin
in PMN
which is adjusted based on symptoms and the desirable efficacy can be achieved.
原发性膜性肾病开阖枢理论太阴温里甘姜苓术汤
primary membranous nephropathyopening closing pivotingtaiyinwarm the interiorGanjiang Lingzhu Decoction
王军,吴彬,权晓玲.《伤寒论》六经体系与《黄帝内经》十二经脉体系的关系刍议[J].中华中医药杂志, 2018, 33(3): 926-928.
南京中医药大学. 伤寒论译释[M].上海:上海科学技术出版社, 2010: 65-68.
冯世纶,张长恩. 胡希恕病位类方解[M].北京:中国中医药出版社, 2018: 7-12.
胡希恕. 胡希恕伤寒论讲座[M].北京:学苑出版社, 2008: 509-510.
刘宝利,赵进喜,刘玉宁,等.论膜性肾病的中医概念与中医药治疗[J].北京中医药, 2019, 38(3): 195-199.
陈明.六经“开、阖、枢”解读[J].北京中医药大学学报, 2021, 44(9): 789-795.
徐传博,孟庆花.基于《伤寒论》太阳、少阴两感证理论治疗荨麻疹[J].中医临床研究, 2023, 15(8): 125-128.
XU X, WANG G, CHEN N,et al. Long-Term Exposure to Air Pollution and Increased Risk of Membranous Nephropathy in China. J Am Soc Nephrol, 2016, 27(12): 3739-3746.
BURBELO PD, JOSHI M, CHATURVEDI A, et al. Detection of PLA2R Autoantibodies before the Diagnosis of Membranous Nephropathy[J]. J Am Soc Nephrol, 2020, 31(1): 208-217.
刘红华,王世荣.从太阴少阴论治蛋白尿浅析[J].中国中西医结合肾病杂志, 2020, 21(9): 809-810.
邓杨春.伤寒气化六经浅析[J].中华中医药杂志, 2016, 31(09): 3399-3404.
付兴,李芊芊,周冉冉,等.三阴三阳之“开阖枢”与“关阖枢”探析[J].中华中医药杂志, 2022, 37(3): 1303-1305.
戴浩然,董兆珵,刘宝利.从胡希恕认识厥阴病辨治慢性肾衰竭[J].环球中医药, 2018, 11(12): 1933-1935.
COUSER WG, STEINMULLER DR, STILMANT MM, et al. Experimental glomerulonephritis in the isolated perfused rat kidney[J]. J Clin Invest, 1978, 62(6): 1275-87.
龚永杰,占永立.从肺、脾、肾论治IgA肾病[J].中医杂志, 2020, 61(11): 1000-1003.
焦雅琳,贺娟.《黄帝内经》“魄汗”探析[J].现代中医临床, 2023, 30(2): 82-85.
王艳丽,吴金玉,史伟.从脾胃论治肾病综合征思路探析[J].北京中医药大学学报(中医临床版), 2007, 14(2): 25-27.
张先闻,王琳,陈以平.陈以平教授治疗儿童特发性膜性肾病经验撷英[J].中国中西医结合肾病杂志, 2017, 18(2): 98-99.
高辰,宋凤丽,康宁,等.温阳消水方外敷神阙穴治疗恶性腹腔积液脾肾阳虚证的临床研究[J].现代中医临床, 2021, 28(4): 12-17.
向玲,邓跃毅,刘旺意,等.邓跃毅教授活血化瘀法治疗膜性肾病经验荟萃[J].中国中西医结合肾病杂志, 2019, 20(03): 189-191.
0
浏览量
66
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构