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杨晓宇,沈佳丽,张颖煜,陈彦霖,易岚,周恩超,高坤.国医大师邹燕勤从血论治膜性肾病[J].湖南中医药大学学报,2022,42(2):176-179[点击复制] |
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| 国医大师邹燕勤从血论治膜性肾病 |
| 杨晓宇,沈佳丽,张颖煜,陈彦霖,易岚,周恩超,高坤 |
| (南京中医药大学附属医院肾内科, 江苏 南京 210029;南京中医药大学附属医院肾内科, 江苏 南京 210029;邹燕勤国医大师传承工作室, 江苏 南京 210029) |
| 摘要: |
| 膜性肾病是以蛋白尿为主要表现的一类肾小球疾病，是临床上难治性肾病之一，其病史缠绵，病程长久。邹燕勤教授认为此类疾病常表现为水瘀互结，应当以保肾气、维护肾元为先，在淡渗利水的同时提出“治水必和络”“经主气，络主血”，常“从血论治”膜性肾病，根据不同证型及病程长短分别采用活血和络、活血化瘀、逐瘀破血法。瘀血证轻或不明显者，药用当归、丹参、牡丹皮等养血和血；病程较长且存在血黏度和血脂高但无明显瘀血癥块者，常用川芎、泽兰、三七、桃仁、红花等活血散瘀；而对久病难愈、瘀血明显者，常选用虫类药如水蛭、虻虫、土鳖虫等破血逐瘀。同时配以理气补益之品，临床疗效显著。 |
| 关键词: 膜性肾病 肾络瘀损 从血论治 活血和络 活血化瘀 逐瘀破血 邹燕勤 |
| DOI：10.3969/j.issn.1674-070X.2022.02.002 |
| 投稿时间：2021-09-12 |
| 基金项目:国家中医临床研究基地（江苏省中医院）开放课题（JD2019SZ10）；江苏中医药科技发展计划项目（YB201913）。 |
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| Traditonal Chinese medicine master Zou Yanqin's treatment of membranous nephropathy from blood |
| YANG Xiaoyu,SHEN Jiali,ZHANG Yingyu,CHEN Yanlin,YI Lan,ZHOU Enchao,GAO Kun |
| (Department of Nephrology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China;Department of Nephrology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China;Zou Yanqin Traditional Chinese Medicine Master Inheritance Studio, Nanjing, Jiangsu 210029, China) |
| Abstract: |
| Membranous nephropathy (MN) is a kind of glomerular disease with proteinuria as the main manifestation. It is one of the refractory nephropathy in clinic. Its history is lingering and its course is long. Professor Zou Yanqin believes that such diseases are often manifested as combination of water and blood stasis. We should first preserve the kidney Qi and maintain the kidney essence. Professor Zou proposed that "regulating water must harmonize the collaterals" and "meridians dominate Qi and collaterals dominate blood" while diluting seepage and enriching water. Therefore, we often use "treatment from blood" to diagnose and treat MN. According to different syndrome types and courses of disease, we should adopt the methods of activating blood and collaterals, improving blood to remove blood stasis, expelling blood stasis and busting blood. If the blood stasis syndrome is mild or not obvious, Danggui (Angelicae Sinensis Radix), Danshen (Salviae Miltiorrhizae Radix Et Rhizoma), Mudanpi (Moutan Cortex) and other nourishing blood and harmonizing blood should be used; for patients with a long course of disease and high blood viscosity and lipid but no obvious blood stasis, Chuanxiong (Chuanxiong Rhizoma), Zelan (Lycopi Herba), Sanqi (Notoginseng Radix Et Rhizoma), Taoren (Persicae Semen), Honghua (Carthami Flos) are commonly used to promote blood circulation and dissipate stasis; for those who have been ill for a long time and have obvious blood stasis, often choose insect medicines such as Shuizhi (Hirudo), Mangchong (Tabanus), Tubiechong (Eupolyphaga Steleophaga) to break blood and remove blood stasis. At the same time, regulating and tonifying Qi products shold be combined with, the clinical effect is remarkable. |
| Key words: membranous nephropathy blood stasis injury of renal collaterals treatment from blood activating blood and collaterals improving blood to remove blood stasis expelling blood stasis and busting blood Zou Yanqin |
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