李建民辨治慢性肾脏病浮阳的经验分析
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摘要
慢性肾脏病的基本病机是脾肾阳虚,或兼夹湿热、血瘀等标实证,其临床表现除了水肿、乏力、畏寒怕冷、小便清长、夜尿多,大便稀溏等阳虚证症状外,阳虚阴寒内盛,格阳于外,虚阳浮越还会出现口舌生疮、咽痛、头痛、失眠等症状,此类症状在慢性肾脏病的辨证过程中常被忽略或错辨。李建民教授在辨治慢性肾脏病过程中对于浮阳的辨识有着丰富的经验,且其尤其注重临床证候与舌象偶联的辨识,临床收效甚佳。文章从定义、病机、辨证论治、病案举例等方面对其经验进行简要分析,以期对年轻中医师临证有一定指导作用。
The basic pathogenesis of chronic kidney disease is yang deficiency of spleen and kidney, or with some secondary sthenia syndrome like humid heat or blood stasis. Except yang deficiency syndrome like edema, fatigue, cold intolerance, clear urine in large amounts, frequent urination at night, loose stool and so on, there is a series of symptoms because of yang repelled by exuberant yin and deficient yang with upper manifestation, like aphtha, pharyngalgia, headache, insomnia and so on, these symptoms are easy to be ignored and discriminated wrongly. Professor LI Jian-min has rich experience which are effective in differentiating floating yang across the course of chronic kidney disease, and during the process he values the connection of clinical syndrome and tongue picture. This paper summarized his experience briefly from the definition, pathogenesis, diagnosis and treatment, case record and so on of floating yang. The aim of this paper is to provide guidance for the young traditional Chinese doctors.
The basic pathogenesis of chronic kidney disease is yang deficiency of spleen and kidney, or with some secondary sthenia syndrome like humid heat or blood stasis. Except yang deficiency syndrome like edema, fatigue, cold intolerance, clear urine in large amounts, frequent urination at night, loose stool and so on, there is a series of symptoms because of yang repelled by exuberant yin and deficient yang with upper manifestation, like aphtha, pharyngalgia, headache, insomnia and so on, these symptoms are easy to be ignored and discriminated wrongly. Professor LI Jian-min has rich experience which are effective in differentiating floating yang across the course of chronic kidney disease, and during the process he values the connection of clinical syndrome and tongue picture. This paper summarized his experience briefly from the definition, pathogenesis, diagnosis and treatment, case record and so on of floating yang. The aim of this paper is to provide guidance for the young traditional Chinese doctors.
引文
[1]GB/T 16751.1-1997.中医临床诊疗术语
[2]李建民,陆红梅,夏松辰.慢性肾衰竭中医辨识思路与对策.中国中西医结合肾病杂志,2017,18(5):377-378
[3]于大君,周群清,徐曼,等.老年慢性肾脏病的中医认识刍议.中华中医药杂志,2017,32(12):5493-5495
[4]李建民,牛丽娜,刘秀萍.糖尿病肾病蛋白尿中医药治疗.现代中医临床,2014,21(3):9-11
[5]刘秀萍,李建民.糖尿病肾病病机演变规律初探.中医学报,2010,25(4):672-673
[2]李建民,陆红梅,夏松辰.慢性肾衰竭中医辨识思路与对策.中国中西医结合肾病杂志,2017,18(5):377-378
[3]于大君,周群清,徐曼,等.老年慢性肾脏病的中医认识刍议.中华中医药杂志,2017,32(12):5493-5495
[4]李建民,牛丽娜,刘秀萍.糖尿病肾病蛋白尿中医药治疗.现代中医临床,2014,21(3):9-11
[5]刘秀萍,李建民.糖尿病肾病病机演变规律初探.中医学报,2010,25(4):672-673