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运用风药特性论治膜性肾病OA北大核心CSTPCD

Using the therapeutic properties of wind herbs to treat membranous nephropathy

中文摘要英文摘要

本文总结运用风药治疗膜性肾病的临床辨治体会.膜性肾病的病位以脾肾为主,以风邪、湿热、血瘀为主要病理要素,脾不升清、肾不化气是膜性肾病的基础病机.风性药物味轻质薄,可疏风散邪,助脾升阳,助肾气化,宣发、疏通气血津液之郁滞,与膜性肾病的风邪外侵、脾肾亏虚、清阳不升、气血壅滞的病机相对应.临床辨治膜性肾病,提出运用麻黄、桂枝、桑叶、菊花、羌活、独活、络石藤、雷公藤、青风藤等风药祛风搜风;羌活、川芎、莪术、穿山甲等活血通络,行气化瘀散结.柴胡、升麻、防风、羌活等辛味药与人参、黄芪等甘味补益药配伍可辛甘化阳而主升,健脾益气结合助脾升阳,可增强补益效果.麻黄、桂枝、生姜、附子、细辛等辛温药可温肾助阳,化气利水.在临床辨治中,综合运用风药特性论治膜性肾病,疗效满意.

We summarize our clinical experience with the use of wind herbs for membranous nephropathy treatment.The pathology of membranous nephropathy is mainly based on the spleen and kidney,with wind pathogen,dampness-heat,and blood stasis as the main pathological factors.The imbalance of the spleen ascending clear and kidney-transforming qi is the fundamental pathogenesis of membranous nephropathy.Wind herbs are light and gentle in nature,and they can dispel wind,assist in raising the spleen yang,aid in kidney qi transformation,and promote the unblocking of qi and blood stasis.This corresponds to the pathogenesis of membranous nephropathy,which involves wind invasion,deficiency of the spleen and kidney,failure to ascend clear yang,and stagnation of qi and blood.In the clinical treatment of membranous nephropathy,the use of wind herbs such as ephedra,cassia twig,mulberry leaf,chrysanthemum flower,and other herbs,along with blood-activating and collateral-opening herbs such as incised notopterygium rhizome and root,rhizome ligustici,zedoray rhizome,and pangolin scales,is proposed.Chinese thorowax root,largetrifoliolious bugbane rhizome,divaricate saposhnikovia,incised notopterygium rhizome and root,and other pungent herbs combined with ginseng,membranous milkvetch root,and other sweet-tonifying herbs can tonify yang and benefit the spleen,enhancing the tonifying effect.Ephedra,cassia twig,fresh ginger,prepared common monkshood branched root,manchurian wildginger,and other pungent-warm herbs can warm the kidney,support yang,and promote qi transformation and water metabolism.In clinical treatment of membranous nephropathy,satisfactory result have been achieved by making use of the characteristics of wind herbs.

曹博宁;王珍

北京中医药大学东直门医院 北京 100700

中医学

风药膜性肾病祛风解表祛湿化痰活血化瘀

wind herbsmembranous nephropathyexpelling wind to relieve superficieseliminating dampness and resolving phlegmpromoting blood circulation and removing blood stasis

《北京中医药大学学报》 2024 (004)

478-484 / 7

国家自然科学基金项目(No.82174342);国家中医药管理局中医药传承与创新"百千万"人才工程项目 National Natural Science Foundation of China(No.82174342)

10.3969/j.issn.1006-2157.2024.04.006

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