| 引用本文: |
张博雅, 赵云, 李博洋, 吴怡平, 秦建国.秦建国教授基于“血实宜决之”理论探讨膜性肾病治疗思路[J].湖南中医药大学学报,2026,46(1):185-189[点击复制] |
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| 秦建国教授基于“血实宜决之”理论探讨膜性肾病治疗思路 |
| 张博雅,赵云,李博洋,吴怡平,秦建国 |
| (北京中医药大学东方医院肾病科, 北京 100078) |
| 摘要: |
| 膜性肾病（MN）是肾病综合征常见的病理类型之一，常规治疗存在不良反应和复发率高等问题。秦建国教授认为“血实在络、肾络瘀损”是MN的核心病机，强调“血实”不仅是MN发生发展的主动因素，亦是疾病迁延难愈的核心要素，治疗上主张以“血实宜决之”为原则，将化瘀通络法贯穿治疗始终，自拟通络益肾方，并根据患者症状体征辨证施治，佐以辛散利水、分清别浊、益肾培元之法，多获良效。附验案一则加以阐明，以期为治疗MN提供新思路。 |
| 关键词: 膜性肾病 血实宜决之 肾病综合征 血实在络 肾络瘀损 |
| DOI：10.3969/j.issn.1674-070X.2026.01.027 |
| 投稿时间：2025-08-13 |
| 基金项目:第五批全国中医临床优秀人才研修项目（国中医药办人教函〔2021〕271号）；北京市中医药管理局北京中医药薪火传承“新3+3”工程项目（京中医科字〔2023〕111号）。 |
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| Professor QIN Jianguo's exploration of the therapeutic strategies for membranous nephropathy based on the theory of "eliminating blood stasis in excess pattern of blood phase" |
| ZHANG Boya, ZHAO Yun, LI Boyang, WU Yiping, QIN Jianguo |
| (Department of Nephrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China) |
| Abstract: |
| Membranous nephropathy (MN) is one of the common pathological types of nephrotic syndrome. Conventional treatments are often associated with risks of adverse effects and high recurrence rates. Professor QIN Jianguo posits that "blood stasis lodged in the collaterals and kidney collateral impairment" constitutes the core pathogenesis of MN. He emphasizes that blood stasis is not only a driving factor in the onset and progression of MN but also a central element contributing to its protracted and refractory nature. Accordingly, he advocates for the therapeutic principle of "eliminating blood stasis in excess pattern of blood phase", consistently applying the method of transforming stasis and unblocking collaterals throughout the treatment course. He has developed the self-drafted Tongluo Yishen Formula as the core prescription, and tailors the treatment based on the patient's symptoms and signs, complemented by auxiliary methods such as dispersing with pungent herbs and promoting urination, separating the clear from the turbid, and tonifying the kidney to reinforce Yuan-primordial qi. Favorable outcomes are frequently achieved. A representative case is appended for illustration, aiming to provide new insights for the treatment of MN. |
| Key words: membranous nephropathy eliminating blood stasis in excess pattern of blood phase nephrotic syndrome blood stasis lodged in the collaterals kidney collateral impairment |
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