摘要
张守琳认为本病病因病机为脾肾亏虚、三焦失序,其关键在于脾肾之虚与三焦气化失常相互影响,打破机体平衡。临床上首创“期-态双维度辨证体系”,通过建立分期定纲、分态立法的动态病机模型,实现对疾病的精准干预。确立了水肿期则以疏风清热、健脾化湿、通利三焦等法缓解症状;精微失守期以培补脾肾、固摄精微为要的治疗原则。再通过辨识风、湿、热、瘀、虚五种病理状态,结合现代药理研究优化用药,形成“宏观调态-微观靶向” 的中西医协同诊疗模式,实现对疾病的精准干预,为特发性膜性肾病的精准治疗提供新思路。
Professor Zhang believes that the etiology and pathogenesis of idiopathic membranous nephropathy feature spleen and kidney deficiency and dysfunction of sanjiao,and the core pathogenesis lies in the mutual influence between deficient spleen and kidney and the abnormal qi transformation of sanjiao,which disrupts the body's balance.Clinically,he pioneers the"period-state dual-dimensional syndrome differentiation system",establishing a dynamic pathogenesis model by setting up period-based guidelines and state-based therapeutic principles to achieve precise intervention in the disease.He proposes that during the edema period,the treatment should focus on relieving symptoms through methods such as dispelling wind,clearing heat,strengthening the spleen,eliminating dampness,and activating sanjiao,while in the period of depletion of essence and qi,the treatment should prioritize invigorating the spleen and kidney and consolidating the essence and qi.By identifying the five pathological states of wind,dampness,heat,blood stasis,and deficiency,and optimizing medication based on modern pharmacological research,a"macroscopic state regulation-microscopic target-oriented"integrated traditional Chinese and western medicine diagnosis and treatment model is formed,achieving precise intervention in the disease and providing new ideas for the precise treatment of idiopathic membranous nephropathy.
作者
姜雨辛
徐佳宁
张湃
包亚丽
张守琳
常明鑫
王子昆
JIANG Yuxin;XU Jianing;ZHANG Pai;BAO Yali;ZHANG Shoulin;CHANG Mingxin;WANG Zikun(Changchun University of Chinese Medicine,Changchun 130117,China;Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021,China)
出处
《吉林中医药》
2025年第8期905-910,共6页
Jilin Journal of Chinese Medicine
基金
吉林省科技发展计划项目(YDZJ2023IZYTS208)。
关键词
特发性膜性肾病
态靶辨治
分期治疗
五态辨治
idiopathic membranous nephropathy
treatment based on syndrome differentiation of states and targets
staged treatment
treatment based on syndrome differentiation of five states
