基于重阳理论探讨复发性尿路感染的辨治

[目的]从重阳理论出发,探讨复发性尿路感染的病因病机和辨证治疗方法,以期为复发性尿路感染的中医治疗提供新视角。[方法]通过查阅古籍文献,结合长期临床实践经验,阐述从重阳理论辨治复发性尿路感染的思路与方法,并举验案加以佐证。[结果]复发性尿路感染主要病机以阳虚为本,阳郁为标,阳虚多责之卫阳不固、中阳不足及肾阳亏虚,而阳郁多责之湿遏、气滞、瘀阻。治疗以扶阳、通阳为基本原则,其中扶阳以固卫助阳、温中补虚、温肾助阳为主,通阳以利湿、行气、化瘀为主,最终达到阳气固、湿邪去、气化通、感染消之目的。所附验案中患者辨证属阳气亏虚、湿阻阳郁证,治疗全程以扶阳、通阳为主,疗效显著。[结论]基于重阳理论辨治复发性尿路感染,临床疗效确切,为扩展丰富复发性尿路感染的辨治体系提供了新思路,对临床具有重要的指导意义。

Differentiation and Treatment of Recurrent Urinary Tract Infection Based on Thought of Paying Importance to Yang

[Objective] To discuss the etiology， pathogenesis and syndrome differentiation of recurrent urinary tract infection(rUTI) from the thought of paying importance to Yang， in order to provide a new perspective for the traditional Chinese medicine treatment of rUTI. [Methods] Through consulting ancient books and literature， combined with long-term clinical practice experience， this paper explains the thoughts and methods of differentiation and treatment of rUTI from the thought of paying importance to Yang， and gives empirical cases to support it. [Results] The main pathogenesis of rUTI is “Yang deficiency”and “Yang depression” based on thought of paying importance to Yang. Yang deficiency includes deficiency defensive Yang， weakness of spleen Yang， deficiency of kidney Yang; Yang depression includes dampness obstruction， Qi stagnation and blood stasis. The treatment takes Yang-reinforcing methods and activating Yang methods as the basic principle. Yang-reinforcing methods mainly include reinforcing defensive Yang， warmly invigorating the spleen and stomach and warming the kidney and enhancing Yang. Activating Yang methods mainly include eliminating dampness and diuresis， regulating Qi-flowing for activating stagnancy and promoting blood circulation for removing blood stasis. Finally， the Yang is strong， the dampness is removed and the bladder gasification is restored. The syndrome differentiation of the patient in the attached case was Yang Qi deficiency and dampness blocking Yang depression. The whole treatment was mainly to reinforc Yang and activate Yang and the curative effect was remarkable. [Conclusion] The thought of paying importance to Yang provides a new idea for expanding and enriching the treatment system of rUTI and has important guiding significance for clinical treatment.