| 王宁玥,杜雨芃,林燕.曹式丽教授从浊毒论治肾病综合征用药经验[J].浙江中医药大学学报,2022,46(4):404-407. |
| 曹式丽教授从浊毒论治肾病综合征用药经验 |
| Experience of Professor CAO Shili in Treating Nephrotic Syndrome by Preventing and Curing Turbid Toxins |
| DOI：10.16466/j.issn1005-5509.2022.04.009 |
| 中文关键词: 肾病综合征 浊毒 三焦 通补兼施 临床经验 验案 曹式丽 |
| 英文关键词: nephrotic syndrome turbid toxins tri-Jiao application of dredging and tonifying clinical experience medical case CAO Shili |
| 基金项目:第四批全国中医临床优秀人才研修项目(国中医药人教发[2017]124号) |
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| 中文摘要: |
| [目的] 总结曹式丽教授从浊毒论治肾病综合征的学术经验。[方法] 通过跟师待诊，收集临床验案，分析曹教授从浊毒致病角度对肾病综合征发生发展过程中病因病机演变及辨治思路的认识，总结常用药物，并附一验案予以佐证。[结果] 曹教授认为，浊毒是肾病综合征发生发展的重要因素。本病以脏虚为本，常起于外感，致使三焦失司，湿留体内，湿渐化浊，更损脏腑，病情缠绵，浊郁成毒，则病重难消，临证时当防微杜渐。曹教授善从三焦论治，尤重通络，偏于实者多根据病位清上渗下、辛开苦降；络脉瘀阻者善用藤类药、虫类药畅达络脉；病久偏虚者则以补为通，养脏和络。所举验案辨证为脾肾亏虚、湿浊内蕴证，曹教授治以健脾祛湿、益肾化浊，中途患者外受风热，又治以清上安下，防邪深入，疗效显著。 [结论] 曹教授从防治浊毒的角度论治肾病综合征，未病先防，既病防变，重在调理三焦，疏通肾络，通补兼施，方简效弘，可供临床参考。 |
| 英文摘要: |
| [Objective] To summarize the academic experience of Professor CAO Shili in treating nephrotic syndrome with the view of turbid toxins. [Methods] Through following Professor CAO's clinical work and collecting clinical cases， Professor CAO's academic points about the etiology， pathological process， syndrome differentiation and treatment thinking of nephrotic syndrome were analyzed， and common drugs were summarized from the perspective of turbid toxins. A medical case is presented at the end of the article， aiming to verify the previous statements. [Results] Professor CAO considers that turbid toxins play an important role in the occurrence and development of nephrotic syndrome. The disease is based on viscera deficiency， and often starts from external causes， which triggers the dysfunction of tri-Jiao， and then gives rise to damp evil stagnation in the body. Damp evil converts to turbid pathogen gradually， weakens the viscera and leading the disease lingering. Turbid pathogen and toxin can transform mutually， thus make the disease seriously. The treatment principle is “preventing turbid toxins from generating and development”. Professor CAO emphasizes the importance of tri-Jiao and collaterals， especially dredging collaterals. The sthenic syndromes should be treated with clearing upper-Jiao， eliminating dampness from lower-Jiao; and smoothing the lifting of middle-Jiao， meanwhile using insect drugs and rattan drugs to dredge collaterals for blood stasis syndrome. With the prolongation of the course， vital Qi is consumed， tonic is the key to medication， combined with nourishing the viscera and harmonizing collaterals. The medical case which belonged to deficiency of the spleen and kidney， internal accumulation of dampness and turbidity， and treatment was based on invigorating the spleen and removing dampness， tonifying the kidney and removing turbidity. When suffered from wind-heat， the therapy regimen was directed to clear the upper-Jiao， protect the lower-Jiao， prevent evil from going deep， finally achieved remarkable curative effect. [Conclusion] Professor CAO treats nephrotic syndrome from the perspective of prevention and treatment of turbid toxins. It is not only prevention before disease， but also preventing disease from exacerbation. The emphasis should be focused on regulating tri-jiao， dredging renal collaterals， application of dredging and tonifying. The prescription is simple and effective， which can be used for clinical reference. |
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