| 张月,雷根平,董盛,等.雷根平教授治疗特发性膜性肾病经验撷菁[J].浙江中医药大学学报,2023,47(1):43-46, 51. |
| 雷根平教授治疗特发性膜性肾病经验撷菁 |
| Professor LEI Genping‘s Experience in the Treatment of Idiopathic Membranous Nephropathy |
| DOI：10.16466/j.issn1005-5509.2023.01.009 |
| 中文关键词: 特发性膜性肾病 辨证论治 六法并施 芪地固肾方 验案 名医经验 雷根平 |
| 英文关键词: idiopathic membranous nephropathy treatment based on syndrome differentiation simultaneous implementation of the six methods Qidi Gushen Recipe medical cases experience of famous doctors LEI Genping |
| 基金项目:陕西教科文卫体系统职工雷根平(劳模)创新工作室(陕教科文卫体工字〔2020〕41号)；陕西省教育厅服务地方科学研究计划项目(18JC009)；陕西省名中医雷根平传承工作室建设项目(2019012) |
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| 中文摘要: |
| [目的] 总结雷根平教授治疗特发性膜性肾病的经验。 [方法] 通过跟诊学习，整理分析典型病案，并参阅相关文献，结合雷教授临证时所谈所述，从病因病机、辨证论治、遣方用药三个层面总结其治疗特发性膜性肾病的经验，并附验案加以佐证。 [结果] 雷教授认为，特发性膜性肾病病性为本虚标实，以脾肾亏虚为本，湿热、瘀血为标，治疗上主张“培、补、固、宣、清、通”六法并施，标本兼治，并自拟芪地固肾方作为基础方剂，经临床检验疗效显著。所举案例辨为脾肾不足、气阴两虚、水湿内蕴证，治以健脾补肾、益气养阴、活血利水，以芪地固肾方为基础方。患者大量蛋白尿，平素情绪易怒易躁，且有高脂血症病史，遂以“活血化瘀”之法贯穿治疗始终，全方“阴阳双补”且以补阴为主，随症加减，用药灵活，治疗1年余尿蛋白显著减少，水肿、失眠及气喘等症状均明显改善。 [结论] 雷教授临床辨治特发性膜性肾病，以益肾健脾、清利湿热、活血化瘀为总治则，思路清晰，用药灵动，组方精良，疗效显著，值得借鉴。 |
| 英文摘要: |
| [Objective] To summarize the experience of Professor LEI Genping in the treatment of idiopathic membranous nephropathy(IMN). [Methods] Through follow-up study， sorting out and analyzing typical medical records， and referring to relevant literatures， combined with the view of Professor LEI in clinical practice， this paper summed up his experience in treating IMN from three levels: etiology and pathogenesis， syndrome differentiation and treatment， and prescription medication， and attached a case to prove it. [Results] Professor LEI maintains that IMN is asthenia in origin and excess in superficiality， taking deficiency of the spleen and kidney as origin， and damp-heat and blood stasis as superficiality. In treatment， he advocates the simultaneous implementation of six methods of “cultivating， tonifying， strengthening， dispersing， clearing and dredging”， treating both the superficiality and origin， and takes self-made Qidi Gushen Recipe as the basic prescription， which has remarkable curative effect in clinic. The cases cited were divided into deficiency of the spleen and kidney， deficiency of both Qi and Yin， and accumulation of water and dampness. The treatment was based on invigorating the spleen and tonifying the kidney， invigorating Qi and nourishing Yin， promoting blood circulation and promoting diuresis， and Qidi Gushen Recipe was used as basic prescription. The patient had a large amount of proteinuria， was usually irritable and had a history of hyperlipidemia， so the method of “promoting blood circulation and removing blood stasis” ran through the treatment. The whole prescription supplemented both Yin and Yang and mainly supplemented Yin， with flexible medication and addition and subtraction with symptoms. After treatment for more than one year， the urinary protein was significantly reduced， and the symptoms of edema， insomnia and asthma were significantly relieved. [Conclusion] Professor LEI‘s clinical syndrome differentiation and treatment of IMN takes tonifying the kidney and spleen， clearing dampness and heat， and promoting blood circulation to remove blood stasis as the general treatment principle， with clear idea， flexible medication， excellent prescription and remarkable curative effect， which is worth learning. |
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