梁晓平从本虚标实分型辨治狼疮性肾炎经验

系统性红斑狼疮为累及多系统损害的慢性自身免疫性疾病,狼疮性肾炎是其最常见且严重的并发症,临床多表现为蛋白尿,血尿,管型尿,甚至肾功能衰竭,进而发展为终末期肾衰。该文系统总结了梁晓平主任医师辨证论治狼疮性肾炎临床经验。梁师认为该病病机总为本虚标实之证,内外相兼,肝肾阴虚为本,热毒血瘀为标。其分型证治可分为热毒壅滞证,肝肾阴虚证,气阴两虚证,脾肾阳虚证四型。以养阴清热,益气温阳为治疗大法,活血化瘀利水法贯穿病程始终。治疗上宜分清标本虚实,轻重缓急,灵活采用清热凉血,养阴清热,益气养阴,脾肾双补等方法。临床上单纯西医治疗单一,西药副作用较大,如果配合中医中药治疗可明显提高临床疗效,并能有效的避免不良反应的发生,减少复发率,从而改善患者预后。

Experience of LIANG Xiaoping in Treating Lupus Nephritis based on Syndrome Differentiation

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple system lesions.Lupus nephritis is the most common and serious complication of SLE.The main clinical manifestations include proteinuria,hematuria,cylindruria and even kideny failure,leading to the end stage renal dise (ESRD).This essay system summarize the clinical experience of LIANG Xiaoping who is a chief physician in the treatment of lupus nephritis based on syndrome differentiation.LIANG Xiaoping considered that the whole pathogenesis of this disease is asthenia in origin and asthenia in superficiality,Yin deficiency of liver and kidney is origin and that heat toxin and blood stasis is symptom.Its classification of syndrome and treatment can divided into four types.They are heat toxicity obstruction,deficiency of Yin in liver and kidney,deficiency of Qi and Yin and Yang deficiency of spleen and kidney.Nourishing Yin and clearing heat as well as benefiting Qi and warming Yang are its treatment.Promoting blood circulation by removing blood stasis throughout the course of disease.The treatment should tell the actual situation of their specimens and order of priority.What’s more,it should smartly adopt methods of reducing fever and cool the blood,nourish Yin and clearing heat,tonifying Qi and Yin,and double nourishing spleen and kidney etc.On the treatment,the pure western medicine treatment is single and the western medicine has great side effects.If it can be combined with Chinese medicine for treatment,the clinical effect will be improved apparently,the occurrence of adverse effect will be efficiently avoided and recurrence rate will be reduced.Thus we can improve prognosis of patients.