余承惠教授治疗肾性贫血经验缬菁
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摘要
肾性贫血为终末期慢性肾脏病的常见并发症,余承惠教授认为正虚邪实贯穿该病始终,其基本病机为脾肾亏虚,痰湿浊毒内生,血络不通,气血失养。病位主要在脾胃,与心肝肺三焦等脏腑相关。治疗以补肾健脾养血为主,配合清热利湿、泄浊解毒、活血化瘀等法。在养血的治疗上侧重于活血凉血兼以养血,养血同时配伍行气药物,使得补而不滞,针对补血治疗上需以平补轻补为主,中药选择上多选择补血活血等药物,慎用血肉有情之品,以免滋补过腻,即使使用,用量宜小。
Renal anemia is a common complication of end-stage chronic kidney disease. Professor Yu Chenghui considers that deficiency and excess are all throughout this disease. Its basic pathogenesis is deficiency of spleen and kidney, endogenous phlegm, dampness, turbidity and toxicity, bloodstream obstruction, dystrophy of qi and blood. Its location is mainly in the spleen and stomach, which is related to the heart, liver, lung and other viscera. The treatment mainly consists of invigorating kidney, strengthening spleen and nourishing blood, combined with the methods of eliminating dampness and turbidity, promoting blood circulation and removing blood stasis. In the treatment of blood-nourishing, emphasis is laid on promoting blood circulation and cooling blood and nourishing blood. Blood-nourishing and compatible with qi-promoting drugs make the tonic not stagnant. Aiming at the treatment of tonifying blood, it is necessary to give priority to gentle tonic, and Chinese medicine should choose more drugs such as tonifying blood and activating blood circulation, and uses sentient flesh and blood of the goods with caution, so as to avoid excessive nourishment, even if used, the dosage should be small.
Renal anemia is a common complication of end-stage chronic kidney disease. Professor Yu Chenghui considers that deficiency and excess are all throughout this disease. Its basic pathogenesis is deficiency of spleen and kidney, endogenous phlegm, dampness, turbidity and toxicity, bloodstream obstruction, dystrophy of qi and blood. Its location is mainly in the spleen and stomach, which is related to the heart, liver, lung and other viscera. The treatment mainly consists of invigorating kidney, strengthening spleen and nourishing blood, combined with the methods of eliminating dampness and turbidity, promoting blood circulation and removing blood stasis. In the treatment of blood-nourishing, emphasis is laid on promoting blood circulation and cooling blood and nourishing blood. Blood-nourishing and compatible with qi-promoting drugs make the tonic not stagnant. Aiming at the treatment of tonifying blood, it is necessary to give priority to gentle tonic, and Chinese medicine should choose more drugs such as tonifying blood and activating blood circulation, and uses sentient flesh and blood of the goods with caution, so as to avoid excessive nourishment, even if used, the dosage should be small.
引文
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[5]詹越,赖俊敏,宋卫国,等.肾性贫血的中医药治疗概况[J].中国民族民间医药,2017,26(17):52-55.
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[12]江燕.余承惠治疗慢性肾炎经验[J].新中医,2012,44(10):152-153.
[13]陈晨,张丽琳,章丹丹,等.12种中药醇提取物对TGF-β1诱导的A549细胞上皮间质转化的干预作用[J].上海中医药杂志,2018,52(10):72-77.
[14]梅雪,余刘勤,陈小云,等.何首乌化学成分和药理作用的研究进展[J].药物评价研究,2016,39(1):122-131.
[15]黄伟哲,肖大伟,杨默,等.何首乌提取物对放射线照射小鼠血小板生成的保护作用[J].汕头大学医学院学报,2013,26(1):9-12.
[16]郭平,王继峰,王升启.芍药苷对放射线所致血虚证小鼠骨髓Epo和G-CSF基因表达的影响[J].山东中医药大学学报,2005,29(3):236.
[17]刘医辉,杨世英,马伟林,等.当归药理作用的研究进展[J].中国当代医药,2014,21(8):192-196.
[18]吴海燕,孙佳明,张辉.阿胶的研究进展[J].吉林中医药,2016,36(1):57-60.
[19]佟艳霞.浅议中药阿胶的临床应用及药理作用[J].中国卫生产业,2013(1):178.
[20]丁进峰,苏秀榕,李妍妍,等.海蜇胶原蛋白肽的免疫活性的研究[J].水产科学,2011,30(6):359-361.
[21]刘巧艳,陈帆,曹世义,等.生血宁片治疗肾性贫血临床效果的Meta分析[J].中国医药导报,2018,15(4):120-125.
[22]刘茂玄,罗杰,王东亮,等.复方阿胶浆对肾性贫血大鼠的治疗作用及其机制[J].中草药,2014,45(3):380-385.
[2] Mc Murray JJV,Parfrey PS. KDIGO clinical practice guidelines for anemia in chronic kidney disease[J]. Kidney Int Suppl,2012,2(4):1-355.
[3]刘明星,张硕,李琦,等.肾性贫血中西医治疗研究进展[J].中国中西医结合肾病杂志,2015,16(6):552-553.
[4]姚春雷,董志刚.董志刚对肾性贫血中医治疗的经验总结[J].辽宁中医杂志,2009,36(2):180-181.
[5]詹越,赖俊敏,宋卫国,等.肾性贫血的中医药治疗概况[J].中国民族民间医药,2017,26(17):52-55.
[6]陈玉龙.“肾主纳气”理论在教学中的阐释[J].专家论坛,2011,18(34):8-9.
[7]周恩超,曾安平,王钢,等.从痰论治慢性肾衰[J].长春中医药大学学报,2007,23(4):132.
[8]戴恩来.慢性肾脏病“毒损肾络”病机概论[J].中国中西医结合肾病杂志,2014,15(2):97-100.
[9]吕贵东.温肾活血化瘀法治疗肾性贫血疗效观察[J].山东中医杂志,2009,9(28):613-614.
[10]韩海燕,路建饶,王新华,等.叶景华治疗肾性贫血经验[J].中医杂志,2013,54(24):2085-2087.
[11]何伟明,江燕,余承惠.余承惠治疗慢性肾衰竭的思路和方法[J].中国中西医结合肾病,2011,12(12):1038-1040.
[12]江燕.余承惠治疗慢性肾炎经验[J].新中医,2012,44(10):152-153.
[13]陈晨,张丽琳,章丹丹,等.12种中药醇提取物对TGF-β1诱导的A549细胞上皮间质转化的干预作用[J].上海中医药杂志,2018,52(10):72-77.
[14]梅雪,余刘勤,陈小云,等.何首乌化学成分和药理作用的研究进展[J].药物评价研究,2016,39(1):122-131.
[15]黄伟哲,肖大伟,杨默,等.何首乌提取物对放射线照射小鼠血小板生成的保护作用[J].汕头大学医学院学报,2013,26(1):9-12.
[16]郭平,王继峰,王升启.芍药苷对放射线所致血虚证小鼠骨髓Epo和G-CSF基因表达的影响[J].山东中医药大学学报,2005,29(3):236.
[17]刘医辉,杨世英,马伟林,等.当归药理作用的研究进展[J].中国当代医药,2014,21(8):192-196.
[18]吴海燕,孙佳明,张辉.阿胶的研究进展[J].吉林中医药,2016,36(1):57-60.
[19]佟艳霞.浅议中药阿胶的临床应用及药理作用[J].中国卫生产业,2013(1):178.
[20]丁进峰,苏秀榕,李妍妍,等.海蜇胶原蛋白肽的免疫活性的研究[J].水产科学,2011,30(6):359-361.
[21]刘巧艳,陈帆,曹世义,等.生血宁片治疗肾性贫血临床效果的Meta分析[J].中国医药导报,2018,15(4):120-125.
[22]刘茂玄,罗杰,王东亮,等.复方阿胶浆对肾性贫血大鼠的治疗作用及其机制[J].中草药,2014,45(3):380-385.