摘要
儿童肾病综合征是临床常见的儿科疾病,其主要表现为大量的蛋白尿、低蛋白血症、高脂血症以及不同程度的水肿。目前,西医学治疗此病时面临主要问题包括患儿激素不敏感、激素依赖以及反复的蛋白尿,部分患儿甚至可发展为终末期肾脏病。中医药的不断发展为临床治疗该病提供了更多的解决方法。儿童肾病综合征属于中医学中“水肿”“肾风”的范畴,诸多医家认为其病因、病机与肺、脾、肾三脏密切相关,国医大师郑新基于肾脏生理病理提出肾病三因论,即诸多肾脏疾病的发生发展都与肺、脾、肾三脏有关。熊维建教授,重庆市名中医,师从国医大师郑新20余载,传承国医大师郑新肾病三因论学术思想,临床治疗儿童肾病综合征以该理论为学术指导。熊维建教授认为小儿肺、脾、肾三脏不足,六淫犯肺,肺气被遏,脾不统水,肾失开阖,发为该病。疾病早期与肺气不足,易受外感相关,治疗时应该重视清肺利咽,防止疾病进展;疾病晚期,脾肾日益不足,水湿、血瘀等病理产物形成,复发亦与伏风、内风潜藏相关,以治肺补肾健脾为基本治法,辅以祛湿化瘀、祛风通络等治法,临床治疗儿童肾病综合征疗效确切。文章通过案例介绍熊维建教授应用肾病三因论辨证论治儿童肾病综合征,以期为临床治疗提供借鉴。
Children’s nephrotic syndrome is a common pediatric disease in clinical practice,characterized by massive proteinuria,hypoproteinemia,hyperlipidemia,and edema of varying degrees.The current main clinical problems in Western medical treatment include insensitivity to steroids,dependence on steroids,and recurrent proteinuria,with some children progressing to end-stage renal disease.The continuous development of traditional Chinese medicine has provided more solutions for clinical treatment of the disease.Nephrotic syndrome in children belongs to the category of“edema”and“kidney wind”in traditional Chinese medicine.Many physicians believe that the etiology and pathogenesis of the disease are closely related to the three internal organs of lung,spleen,and kidney.National Medical Master ZHENG Xin,based on the physiology and pathology of the kidney,proposed the nephrosis three-cause theory,which states that the occurrence and development of many kidney diseases are related to the three internal organs.Professor XIONG Weijian,a Famous traditional Chinese Medicine Voctor in Chongqing and a disciple of medical master ZHENG Xin for more than 20 years,has inherited ZHENG Xin’s academic thought of the nephrosis three-cause theory and uses it as the guiding principle for clinical treatment of children’s nephrotic syndrome.Professor XIONG Weijian believes that children’s lung,spleen,and kidney are insufficient,and that the six pathogenic factors invade the lungs,causing the suppression of lung Qi(气),the failure of the spleen to control water,and the loss of the opening and closing of the kidneys,leading to the disease.In the early stage of this disease,it is related to insufficient lung Qi and susceptibility to external infections.Therefore,in the treatment,attention should be paid to clearing the lungs and promoting throat health to prevent further progression of the disease.In the late stage of the disease,the spleen and kidney are increasingly insufficient,and pathological products such as water retention and blood stasis are formed.The recurrence of the disease in children is also related to the latent presence of wind and internal wind.Therefore,the basic treatment method of treating the lungs,kidneys,and spleen is proposed,supplemented by treatments such as removing dampness and resolving blood stasis,and removing wind and dredging the meridians.The clinical treatment on pediatric nephrotic syndrome has achieved definite results.This article introduces the treatment of children’s nephrotic syndrome based on the nephrosis three-cause theory through case studies,aiming to provide insights for clinical treatment.
出处
《中医临床研究》
2025年第11期105-109,共5页
Clinical Journal Of Chinese Medicine
基金
重庆市自然科学基金面上项目(CSTB2024NSCQ-MSX1256)。
关键词
儿童肾病综合征
肾病三因论
水肿
Children’s nephrotic syndrome
Nephrosis three-cause theory
Edema
