中医药学报2023，Vol.51Issue(12)：5-9,5.DOI:10.19664/j.cnki.1002-2392.230248
基于阴火学说探讨IgA肾病的中医治疗
Discussion on the Chinese Medicine Treatment of IgA Nephropathy Based on the Theory of Yin Fire
摘要
Abstract
IgA nephropathy(IgAN)is the most common primary glomerular disease in China.The basic Traditional Chinese Medicine(TCM)pathogenesis of IgAN is spleen and kidney qi deficiency combined with damp-heat.The theory of yin fire is an important part of Li Dongyuan's academic thoughts.The pathogenesis of yin fire is that yin fire is internally generated due to spleen-stomach source qi deficiency.The therapy of tonifying the middle,raising yang and downbearing fire is the main treatments for yin fire.The basic pathogenesis of IgAN is similar to the pathogenesis of yin fire.We have draws lessons from Li Dongyuan's experiences and mainly use the method of"tonifying the middle(spleen and stomach),raiseing yang,removing dampness,and downbearing fire"to treat IgAN of spleen and kidney qi deficiency and damp-heat type.If deficient root is the main case,the patients should be treated with center-supplementing formulae,such as Middle-Tonifying Qi-Replenishing Decoction,and Four Gentlemen Decoction,plus yang wind raising medicinals,such as Chaihu(radix bupleuri),Shengma(rhizoma cimicifugae)and Qianghuo(rhizoma seu radix notopterygii)to regulate qi mechanism,raise yang qi,restore source qi to the normal state,and supplement the middle.If the pattern is in severe excess in superficiality and dampness predominating over heat,bland medicinals should be employed,such as Fuling(poria cocos),Zhuling(polyporus umbellatus)and Zexie(alisma orientalis),to drain dampness.Yang wind raising medicinals can be added,such as Gegen(puerariae radix),Shengma(rhizoma cimicifugae),Fangfeng(saposhnikovia radix)and Chaihu(radix bupleuri),to raise yang-qi and promote spleen qi,because these medicinals are pungent,have dispersing nature,and can disperse dampness.If heat predominates over dampness,bitter-cold medicinals can be added,such as Huanglian(coptidis rhizoma),Huangbo(phellodendri chinensis cortex)and Huangqin(scutellariae radix)to reduce yin-fire,and yang wind raising medicinals can be added,such as Fangfeng(saposhnikovia radix),Qianghuo(rhizoma seu radix notopterygii),Chaihu(radix bupleuri),Shengma(rhizoma cimicifugae),to dissipate yin-fire.This way,the middle deficiency can be supplemented,damp-heat can be eliminated,yang qi can be raised,and source qi can be restored,and therefore,the yin fire can spontaneously regress.While in clinical practice,one should consider the proportion and handle simplicity and complexity.关键词
阴火学说/升阳法/IgAN/脾肾气虚/湿热Key words
Yin fire theory/Yang raising method/IgAN/Spleen and kidney qi deficiency/Damp-heat分类
医药卫生引用本文复制引用
任飞鸿,金秋百,刘童童,占永立..基于阴火学说探讨IgA肾病的中医治疗[J].中医药学报,2023,51(12):5-9,5.基金项目
国家自然科学基金面上项目(82074393) （82074393）
