摘要
[目的]总结吴国伟治疗IgA肾病的临床经验。[方法]分析吴国伟治疗IgA肾病的诊治思路,总结其对IgA肾病的辨证思路及治疗用药,并分析一则典型案例。[结果]吴国伟认为,IgA肾病发生发展的核心病机为本虚标实,与“风、毒、瘀、虚”密切相关。在本病早期或疾病发作期以风、毒之邪实为主,并根据不同的兼夹与毒邪性质的不同,而采取不同的辨证论治法则,在祛邪的同时也不忘扶正;在本病中后期,以脾肾亏虚为主,故治疗上以健脾益肾为主,并根据阴阳虚实的不同而采取不同的治法方药;瘀阻肾络伴随本病病理全过程,故“活血化瘀消癥”贯穿整个治疗的始终。所附医案肾活检病理诊断IgA肾病,中医诊为水肿,属风热犯肺兼湿毒浸淫证,治以疏风清热解毒、止咳利水活血,取得较好疗效。[结论]吴国伟治疗IgA肾病从“风、毒、瘀、虚”出发,辨证辨病相结合,取得显著的疗效,其临床经验值得学习和推广。
[Objective Objective]To summarize WU Guowei’s clinical experience in treating IgA nephropathy.[Methods Methods]Analyze WU Guowei’s diagnosis and treatment of IgA nephropathy,summarize his syndrome differentiation and treatment of IgA nephropathy,and analyze one typical case for proof.[Results Results]WU Guowei believes that the core pathogenesis of IgA nephropathy is deficiency of origin and substance,which is closely related to“wind,poison,stasis and deficiency”.In the early stage or the onset of the disease,the evil substance of wind and poison is the main factor,and according to the different characteristics of different concurrence and toxin,it adopts different syndrome differentiation and treatment rules,while removing the evil,but also does not forget to strengthen the body resistance;In the middle and late stages of this disease,the spleen-kidney deficiency is the main factor,so the treatment is mainly to strengthen the spleen and kidney,and according to the difference of Yin and Yang deficiency,different treatment methods and prescriptions are taken.Stasis of kidney collateral is accompanied by the whole pathological process of the disease,so“promoting blood circulation and removing blood stasis”runs through the whole treatment.The attached medical case was edema,which was a syndrome of lung invaded by wind-heat and damp toxin,treated with opening wind,clearing heat and detoxification,relieving cough,promoting water and blood circulation,and achieved good curative effect.[Conclusion Conclusion]WU Guowei’s treatment of IgA nephropathy starts from“wind,poison,stasis and deficiency”,and the combination of syndrome differentiation and disease differentiation has achieved remarkable curative effect.His clinical experience is worth learning and promoting.
作者
徐文君
吴德鸿
程汀燕
吴国伟
XU Wenjun;WU Dehong;CHENG Tingyan(Kaihua Hospital of Traditional Chinese Medicine,Kaihua(324300),China;The Second Affiliated Hospital of Zhejiang Chinese Medical University)
出处
《浙江中医药大学学报》
2025年第1期65-68,共4页
Journal of Zhejiang Chinese Medical University
基金
浙江省名老中医专家传承工作室建设项目(GZS2020048)
衢州市科学技术局项目(2023K199)。
关键词
IGA肾病
辨证
辨病
毒邪
脾肾亏虚
瘀阻肾络
名医经验
吴国伟
IgA nephropathy
pattern differentiation
disease differentiation
toxic pathogenic factor
spleen and kidney deficiency
obstruction of the kidney channels by blood stasis
famous doctor’s experience
WU Guowei
