开上利下法治疗肺闭型肾炎的体会

开上利下法,又称提壶揭盖法,是用宣肺利水的药物治疗肾炎水肿的一种方法,而对肺闭型肾炎疗效尤其显著。所谓开上即是宣肺,因为水液在人体内新陈代谢,有赖于肺的输布,脾的运化,肾的调节。水液代谢与脾肾关系固然重要,但肺为水之上源,肺气不宣,肃降无权,不能通调水道、下输膀胱而致肾炎水肿者,临床上累见不鲜。正如《金匮发微》一书所指出的,因为大气不运则里气不疏,肺气不开则肾气不     

中医问题解答(二)

3.肺主宣降有何临床意义? “宣”,宣发布散;“降”,清肃下降。肺气宣发,则布散卫气和津液,充养全身;肺气肃降,则呼吸之气和顺,并使人体水液通调。在正常情况下,肺气的宣发和肃降是相辅相成的,宣发有利于肃降,肃降有助于宣发。只有肺气宣降功能协调,才能使气道通畅,水液代谢正常。如果宣降不相协调,就是疾病产     

基于肺气虚证探讨肺系疾病的理论、临床和实验研究

肺气虚常出现卫外功能减退,呼吸功能失常,从而出现治节功能障碍。根据中医理论且结合临床实际,将肺气虚证可分为轻、中、重三度。当前关于肺气虚证本质研究成为热点,为运用现代医学手段来研究肺气虚证本质提供了思路。肺气虚证本质研究采用的方法包括心功能、肺功能检查、肺部影像学检查、血液流变学、细胞能量代谢、植物神经功能状态、生化学、免疫学、代谢组、蛋白组及基因芯片等,涉及慢性阻塞性肺疾病、肺心病、慢性支气管炎等疾病。笔者根据近年来关于肺气虚证的研究概括如下,以进一步揭示肺气虚证的本质特征。     

中医问题解答

何谓“提壶揭盖”法?临床上有何意义?“提壶揭盖”法,是对小便不通利而采用宣通肺气、通畅小便的一种治疗方法,是根据《内经》所说“饮入于胃,游溢精气,上输于脾,脾气散精,上归于肺,通调水道,下输膀胱,水精四布,五经并行。而制订的治疗原则。临床常用于因肺气不降,通调水道不利,致使水液输布和排泄障碍,水湿潴留的小便不利、水肿等病患。例如外邪束肺,肺气不宣,导致腠理闭塞、无汗、水肿等症,采用解表发汗,宣散肺气的“提壶揭盖”法,就可有利尿作用,使小便通畅,水肿消散。     

小青龙汤加减治疗老年慢性支气管炎急性发作期60例

慢性支气管炎是由感染或非感染因素引起气管、支气管粘膜及周围组织的慢性非特异性炎症。老年慢性支气管炎是老年人在临床上常见的呼吸道疾病，一年四季均可发病，但以寒、冷、湿偏重的冬春两季最为多见。此病病程长，易复发，治疗上颇为棘手，临床上以反复发作的咳嗽、咳痰或伴见喘息为特征，严重的可以导致肺气肿、肺心病。中医认为本病是由于痰浊阻肺、寒饮内伏、肝火犯肺等造成，肺气闭阻或肺气上逆，升降失司的病证，病在肺，根在脾肾，     

慢性肾脏病合并结核感染诊治进展

慢性肾脏病（Chronic kidney disease ,CKD）和结核病是危及人类健康的慢性疾病,慢性肾脏病患者感染结核的风险增加,与CKD的进展有关,且肺外结核发生率高,临床症状不典型,结核相关筛查实验阳性率低,CKD患者抗结核药物副作用较普通人群高且严重,预后更差,早期诊断及及时治疗对改善预后有重要意义。     

小儿急性肾炎中医辨证施治

急性肾炎是儿科常见病、多发病之一。多见于3～12岁的儿童。本文在总结我院十年来治疗小儿急性肾炎临床资料的基础上,简要介绍我们对本病辨证施治的体会。一、祖国医学对小儿急性肾炎的认识急性肾炎以浮肿、少尿为主要临床表现,可同时伴有不同程度的血尿、高血压等。本病属于祖国医学水肿病中“阳水”的范畴。水肿病的发病与肺、脾、肾三脏功能失调有关。因肺为水之上源,肺气通调,则水得下行;肺气不宣,不能通调水道、下输膀胱,致水液不得下行而泛滥肌肤。脾主运化,脾运失司,则     

慢性支气管炎病人的中西医结合护理

慢性支气管炎是呼吸系统常见的多发病,以慢性咳嗽、咳痰或伴有喘息及反复发作为临床特征。后期可发展为阻塞性肺气肿和肺源性心脏病。[1]属祖国医学"咳嗽"、"喘证"等范畴。发病机理与外邪反复侵袭和内脏亏损有关,特别是肺、脾、肾等脏腑的功能失调密切相关,如久咳伤肺,肺气不足;久病脾虚,聚湿生痰;肾不纳气,肺气上     

慢性肾脏病临床特征及中医治疗思路探讨

慢性肾脏病(chronic kidney disease,CKD)是一种起病隐匿、病程较长、肾功能渐进性损伤的临床综合征,研究表明,中医在治疗CKD中有独特的优势,中药治疗在缓解CKD患者的症状,保护残余肾功能,延缓病程进展中有很大的潜力.作者通过对CKD的中医病因病机认识,分析CKD各期临床特点,总结了CKD临床特征,以CKD病因病机及临床特征,探讨中医在CKD的治疗思路,阐述治则治法,为临床治疗提供一些治疗思路,以期提高临床疗效,延缓CKD进入终末期肾病的时间.     

慢性阻塞性肺疾病的整体护理查房

护士长:慢性阻塞性肺疾病是呼吸系统疾病中常见的一种疾病,大多数肺气肿患者伴有咳嗽、咳痰病史,很难和慢性支气管炎截然分开,故临床上将气道阻塞特征的慢支和肺气[1]     

李明权治疗慢性肾脏病夜尿症经验

本文介绍李明权教授中医治疗慢性肾脏病(CKD)夜尿症的经验。李教授认为CKD患者夜尿增多病位主要在肾与膀胱,与肺、脾胃、肝及三焦也有密切联系。辨证时应以肾虚为本,夜尿多为标,治疗时不可单纯利水渗湿,应认识其病因病机,辨证论治,随症加减,兼顾患者的睡眠与情志,利大便,中西结合从而提高临床疗效。     

Prevention of CVD in patients with CKD

Chronic kidney disease (CKD) is characterized by proteinuria and kidney dysfunction caused by multiple factors. Metabolic disorders such as diabetes, dyslipidemia and hypertension are involved in the underlying pathological mechanisms of CKD and cardiovascular disease (CVD). In patients with CKD, CVD is a major cause of morbidity and mortality. Recent clinical studies have revealed that intervention by angiotensin II blockade with ARB and ACEI reduces CKD and CVD. Accordingly, earlier intervention to metabolic disorders with blockers for angiotensin II and aldosterone may prevent CKD as well as CVD associated with CKD.     

慢性肾脏病合并感染的治疗

慢性肾脏病(ChronicKidneyDiseases,CKD)是临床上常见的疾病,是肾小球肾炎、肾盂肾炎、肾病综合 征、肾小管间质性疾病、糖尿病肾病、高血压肾病、肾血管性疾病等绝大多数肾脏疾病的统称。CKD患者极易并发各 种感染,促使肾功能进一步恶化造成慢性肾脏衰竭(ChronicRenalFailure,CRF),直接影响患者的生存质量,并常常 是患者的直接死因。因此,了解CKD感染的危险因素及其特点,并积极控制感染,是提高CKD诊疗水准、改善患者预 后的一项重要措施。     

Causes and characteristics of CKD

Chronic kidney disease (CKD) is common in Japan and worldwide. The estimated prevalence of CKD in Japanese adults was 10.6% in 2005, based on the survey conducted by the Japanese Society of Nephrology. The most common risk factors for CKD include diabetes, hypertension and cardiovascular disease. Major outcomes of CKD include progression to kidney failure and increased risk for cardiovascular disease. CKD is usually silent until its late stages, thus many patients with CKD are detected only shortly before the onset of symptomatic kidney failure, when there are few opportunities to prevent adverse outcomes. Earlier detection allows for more time for evaluation and treatment but requires explicit testing strategies for asymptomatic individuals at increased risk. Understanding the strengths and limitations of CKD testing and risk factors of CKD is critical for appropriate management of CKD patients. The goal of this paper is to discuss CKD testing and early detection in clinical practice and its application to public health initiatives, with attention to limitations and appropriate interpretation.     

Genetics of chronic kidney disease

The current review collates what is already known of the genetics of chronic kidney disease (CKD), and focuses on new trends in genome-wide assessment of the inherited component of susceptibility to this condition. Early efforts to identify kidney disease susceptibility genetic loci using linkage and candidate gene strategies proved disappointing. More recently, genome-wide association studies have yielded highly promising results suggesting a number of potential candidate genes and genomic regions that may contribute to the pathogenesis of CKD. Renal failure susceptibility genes identified by these methods, such as MYH9, have yielded novel insights into the pathogenesis of CKD. Genome-wide association studies of CKD are beginning to define the genomic architecture of kidney disease and will impact our understanding of how genetic variation influences susceptibility to this condition.     

Hypertension complicated with chronic kidney disease

Hypertension causes exacerbation of chronic kidney disease (CKD) and vice versa. CKD has been known as an independent risk factor for death from cardiovascular disease (CVD). Proteinuria and albuminuria indicate progressive kidney injury and are risk factors for end-stage renal disease(ESRD). Corrections of blood pressure and proteinuria or albuminuria reduce the risk of occurrence of CVD and progression to ESRD. Antihypertensive therapy in CKD includes the management of salt sensitivity and renin angiotensin system. Diuretics more effectively contribute to the balance of sodium and volume of water, when used with ACE inhibitor and ARB. Direct renin inhibitor has been available and shown potential to be a first choice for the treatment of hypertension in CKD.     

Rate of change in kidney function and the risk of death: the case for incorporating the rate of kidney function decline into the CKD staging system

Chronic kidney disease (CKD) is associated with increased risk of death. A wave of recent studies used longitudinal data to examine the effect of the rate of decline of kidney function on the risk of death. The results from these studies show that there is an independent and graded association between the rate of kidney function decline and the risk of death. There is a need to incorporate the rate of decline in the definition of CKD. This redefinition of CKD will transform a static definition into a dynamic one that more accurately describes the disease state in an individual patient.     

Cardiovascular risk in chronic kidney disease: what is new in the pathogenesis and treatment?

The prevalence of chronic kidney disease (CKD) has increased markedly over past decades due to the aging of the worldwide population. Despite the progress in the prevention and treatment, the cardiovascular (CV) morbidity and mortality remain high among patients with CKD. Although CKD is a progressive and irreversible condition, it is possible to slow decreasing kidney function, as well as the development and progression of associated with kidney disease comorbidities. Diabetes mellitus has become major cause of CKD worldwide. It is estimated that the prevalence of diabetes will increase from 425 million worldwide in 2017 to 629 million by 2045, substantially the percentage of diabetic nephropathy among CKD patients is set to rise markedly. The results of multicenter trials concerning novel antidiabetic drugs suggest that efficacy in reducing CV risk is independent of the improvement in glycemic control. This review discusses underlying causes of high CV risk and strategies reducing individual burden among CKD patients.     

Genetics of kidney failure and the evolving story of APOL1

Chronic kidney disease (CKD) results from a wide array of processes that impair the kidney's ability to perform its major functions. As many as 20 million Americans suffer from CKD and nearly a half million from end-stage renal disease, but there are also examples of centenarians with adequate renal function. Family-based and genome-wide studies suggest that genetic differences substantially influence an individual's lifetime risk for kidney disease. One emerging theme is that evolution of genes related to host defense against pathogens may limit kidney longevity. The identification of these genetic factors will be critical for expanding our understanding of renal development and function as well as for the design of novel therapeutics for kidney disease.