|
|
基于脾肾亏虚–痰瘀互结理论浅析难治性特发性膜性肾病
|
Abstract:
本文主要是从脾肾亏虚、痰瘀互结两个角度讨论难治性特发性膜性肾病的发病病因病机及治疗，认为本虚标实为疾病的基本特点。疾病初期水液与湿热互结，久则化痰成瘀，加之患者素体本虚，虚实夹杂，致使病情缠绵难愈。治疗上强调标本兼治，补虚不忘祛邪外出，同时认为预防与调护对于难治性特发性膜性肾病的治疗及预后也相当重要。
This paper mainly discusses the etiology, pathogenesis and treatment of refractory idiopathic membranous nephropathy from the perspectives of spleen and kidney deficiency and sputum and stasis, and believes that this deficiency is the basic feature of the disease. In the early stage of the disease, the water and humidity and heat are intertwined, and the phlegm will become stasis for a long time, coupled with the patient’s physical deficiency, virtual and real inclusions, resulting in the disease lingering and difficult to heal. At the same time, it is believed that prevention and care are also very important for the treatment and prognosis of refractory idiopathic membranous nephropathy.
| [1] | Sethi, S. (2021) New ‘Antigens’ in Membranous Nephropathy. Journal of the American Society of Nephrology, 32, 268-278. https://doi.org/10.1681/ASN.2020071082 |
| [2] | 刘纹, 许勇芝. 难治性特发性膜性肾病诊治进展[J]. 海南医学, 2021, 32(4): 511-515. |
| [3] | 刘畅, 苑天彤. 近10年难治性特发性膜性肾病临床研究概况[J]. 中医药临床杂志, 2023, 35(2): 404-410. |
| [4] | 李锋, 膜性肾病不同治疗方案临床疗效的对照研究[J]. 中国中西医结合肾病杂志, 2021, 22(7): 635-637. |
| [5] | 罗曼宇, 刘丽华, 刘声茂, 张冬梅. 不同治疗方案对特发性膜性肾病疗效的临床对照研究[J]. 临床肾脏病杂志, 2019, 19(11): 798-802. |
| [6] | 刘玉宁, 谢院生, 方敬爱. 雾霾致膜性肾病的中医病机探讨与治疗思路[J]. 中国中西医结合肾病杂志, 2022, 23(11): 941-943. |
| [7] | 吴双, 傅强, 孙瑞茜, 等. 吕仁和运用“六对论治”法治疗特发性膜性肾病经验[J]. 新中医, 2022, 54(22): 177-183. |
| [8] | 刘竹生, 陈贤, 黄雪萍. 益肾汤防治激素副作用临床分析[J]. 实用中医药杂志, 2007, 23(3): 141-142. |
| [9] | 饶克琅, 皮持衡. 皮持衡教授对激素副反应的中医病机探析及临证经验[J]. 四川中医, 2011, 29(8): 9-10. |
| [10] | McAdoo, S.P. and Pusey, C.D. (2016) Clustering of Anti-GBM Disease: Clues to an Environmental Trigger? Clinical Journal of the American Society of Nephrology, 11, 1324-1326. https://doi.org/10.2215/CJN.05580516 |
| [11] | 李中梓. 医宗必读[M]. 江厚万, 点评. 北京: 中国医药科技出版社, 2018. |
| [12] | 马赟, 仝新强, 马二卫, 等. 温阳通络方联合非免疫抑制治疗特发性膜性肾病脾肾阳虚、风湿瘀痹证的临床研究[J]. 河北中医, 2023, 45(1): 35-38. |
| [13] | 周艳利, 蒙向欣, 李辉远, 等. 益肾通络法辨治特发性膜性肾病临床探析[J]. 河实用中医药杂志, 2022, 38(5): 849-852. |
| [14] | 于翔, 祝一叶, 孔薇, 等. 国医大师邹燕勤治疗膜性肾病经验浅析[J]. 中华中医药杂志, 2022, 37(10): 5739-5742. |
| [15] | 刘杰, 钟娇影, 朱昭明. 芎蛭通络胶囊治疗瘀血阻络型膜性肾病患者的临床效果及其对血清抗PLA2R抗体水平的影响[J]. 广西医学, 2022, 44(24): 2876-2879+2890. |
| [16] | 刘海平, 马赟, 等. 陈志强教授以“辨病辨证”论治特发性膜性肾病的经验[J]. 现代中西医结合杂志, 2022, 31(21): 2985-2988+3026. |
| [17] | 卢占锋, 郭献亭. 中医药防治糖皮质激素副反应临床观察[J]. 河南中医, 2005, 25(7): 39-40. |
| [18] | 陈俭. 激素治疗中对其副反应的辨证施护[J]. 辽宁中医杂志, 2000, 27(1): 43-43. |
| [19] | 贠清亮. 对激素副反应的认识与用药心得[J]. 中医药信息, 2002, 19(1): 1-2. |
| [20] | 戴征浩, 石君华, 易茗, 柯珂. 基于发病因素与中医证型探讨“治未病”思想在特发性膜性肾病中的应用[J]. 饮食保健, 2020(40): 113-114. |
