实用中医内科杂志2026，Vol.40Issue(8)：89-92,4.DOI:10.13729/j.issn.1671-7813.Z25102901
阮诗玮横纵辨证视域下从湿论治肾性血尿
Professor Ruan Shiwei's Experience in Treating Renal Hematuria from the Perspective of Dampness Based on Horizontal Vertical Syndrome Differentiation
摘要
Abstract
This article summarizes Professor Ruan Shiwei's clinical experience in treating Renal Hematuria(renal he-maturia,RH)based on the theory of Horizontal and Vertical Syndrome Differentiation,with dampness as the central patho-genic focus.Professor Ruan considers dampness as the key pathological factor in the onset and progression of RH.Damp-ness tends to obstruct the Ying(Nutrient)and Wei(Defense)systems,transforming into heat;impairs the qi transforma-tion of the Sanjiao,giving rise to turbidity;and induces stagnation in the renal collaterals,leading to blood stasis,thereby precipitating the disease.Consequently,RH typically follows the pathological progression from dampness-heat to damp-ness-turbidity and ultimately to dampness-stasis.Based on this,the core pathogenesis of RH is proposed as disharmony between the Horizontal and Vertical dimensions,transformation of dampness-heat into turbidity,collateral damage,and blood stasis.Specifically:From the Horizontal perspective(Wei-Qi-Ying-Xue Syndrome Differentiation),the initial stage of RH involves obstruction of the Ying and Wei systems,leading to endogenous dampness-heat.From the Vertical perspec-tive(Sanjiao Syndrome Differentiation),impaired qi transformation of the Sanjiao,producing endogenous dampness-turbid-ity,is a key factor in the progression of RH.The final outcome results from the interwoven disharmony of both Horizontal and Vertical dimensions,forming intractable endogenous dampness-stasis.Accordingly,from the"Horizontal and Vertical Syndrome Differentiation"perspective,Professor Ruan's specific treatment strategies for RH are as follows:For RH charac-terized by Ying-Wei stagnation and dampness-heat contention:Modified Qiaohe Tang combined with Shangjiao Xuanbi Tang are used to diffuse Ying-Wei,disperse dampness,and clear heat.For RH characterized by qi transformation failure and downward flow of dampness-turbidity:Shengyang Yiwei Tang is employed to uplift clear Yang,transform qi,drain dampness,and eliminate turbidity.For RH characterized by dampness-turbidity persisting for a long time,lingering in the kidney collaterals and eventually leading to stasis,with dampness and stasis intermingling in an intractable entanglement:Zi Qian Ningxue Tang combined with Mahuang Lianqiao Chixiaodou Tang are applied to eliminate dampness,dispel sta-sis,cool the blood,and dispel pathogens.This approach aims to provide new insights for the syndrome differentiation and treatment of RH.关键词
肾性血尿/横纵辨证/湿热/湿浊/湿瘀/名医经验/阮诗玮Key words
renal hematuria/horizontal and vertical syndrome differentiation/dampness-heat/dampness-turbidity/dampness-stasis/famous doctor's experience/RUAN Shiwei分类
医药卫生引用本文复制引用
蔡晓津,杨运劼,翁晓娟,黄定,郑焯文,王建挺..阮诗玮横纵辨证视域下从湿论治肾性血尿[J].实用中医内科杂志,2026,40(8):89-92,4.基金项目
国家中医药管理局阮诗玮全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号) （国中医药人教函[2022]75号）
福建省中医药管理局省级中医优势专科建设项目(闽中医药函[2026]20号) （闽中医药函[2026]20号）
福建中医药大学附属人民医院中医临床优秀人才研修培养项目(闽人院[2024]217号) （闽人院[2024]217号）
