刘文军教授运用升降散加减治疗慢性肾炎验案1则

升降散是清代温病大家杨栗山为治疗"表里三焦大热,其证不可名状"所设,其主要病机特点是外感邪热、火热内郁。该方经后世医家发展,灵活运用于临床,凡具外邪束表、里有郁热或湿热内蕴者,均可随证加减化裁,治疗多系统疾患。刘文军教授精研伤寒、温病等中医经典,并结合多年临床经验,认为慢性肾炎之中医病机既有伏邪为患,又有气机升降失常,后期更有络脉瘀阻;其中以外邪、湿热、血瘀为标;又肺、脾、肾3脏不足为本,各因素互为因果,然总为本虚标实、虚实夹杂。刘教授通过临证经验总结,认为升降散一从伏邪立论,二从升降立论,三从络病立论。治病求本,谨守气机失畅、湿热内蕴、络脉瘀阻之机,确立解表祛邪、升清降浊、调气活血之法,用于治疗慢性肾炎效果尤佳。

A case of Professor LIU Wenjun's treatment of chronic nephritis with Shengjiang Powder

Shengjiang Powder was established by YANG Lishan,a famous warm disease master in Qing Dynasty,for the treatment of "exterior and interior triple energizer heat,with unexplainable syndrome". Its main pathogenesis features are exogenous pathogenic heat,and internal heat depression. This recipe has been developed by later physicians and applied flexibly in clinical practice. For those with exterior pathogenic factors and interior stagnation heat or damp-heat accumulation,it can be modified according to the syndrome to treat multi-system diseases. Professor LIU Wenjun has carefully studied the classics of traditional Chinese medicine,such as Typhoid Fever and Epidemic Febrile Diseases,and combined with many years of clinical experience,he believes that the traditional Chinese medicine for chronic nephritis is characterized by pathogenic factors,abnormal ascending and descending of qi activity,and collateral stasis at the later stage. Among them,exogenous pathogens,damp-heat and blood stasis are branch. Moreover,the deficiency of lung,spleen and kidney is the root,and each factor is cause and effect. However,it is always the root of deficiency with branch excess and deficiency with excess. Based on the summary of clinical experience,Professor LIU believed that Shengjiang Powder was based on pathogenic factors,ascending and descending,and collateral diseases. To treat the disease and seek the root,we should observe the mechanism of qi stagnation,damp-heat accumulation and collateral stasis,and establish the methods of relieving exterior syndrome,eliminating pathogenic factors,ascending and descending turbidity,regulating qi and promoting blood circulation,which are especially effective in treating chronic nephritis.