陈志强教授治疗肾病综合征学术思想与临床经验介绍

Professor CHEN Zhiqiang's academic thoughts and clinical experience of the treatment on the nephrotic syndrome

关键词:  肾病综合征  学术思想  临床经验  主体病机  客体病机  陈志强

Key words:  nephrotic syndrome  academic thought  clinical experience  unchanged pathogenesis  changed pathogenesis  CHEN Zhiqiang

摘要:

陈志强教授从事中医肾脏病临床、科研工作30 余年，擅于将中医学与西医学有机结合，在慢性肾脏疾病诊疗中积累了丰富的临床经验，并提出了许多有临床实用价值的学术见解，创造性地提出了主体病机与客体病机的新理念，并将此学术思想应用于临床，取得了较好的临床疗效。文章主要对陈教授诊治肾病综合征的学术思想作一概述，主要包括以下两个方面：1）主体病机与治法：提出脾肾气阳两虚、水湿瘀血内停为肾病综合征的基本病机，并将其称之为主体病机，据此提出了益气温阳、化湿利水、活血通络的基本治法。2）客体病机与治法：将肾病综合征病情演变过程中常因感受外邪或药源性因素影响而出现的变证称之为客体病机，并据其变证的不同分别予以相应的治法方药：若感受风寒或风热之邪，应分别治以疏风散寒或疏风清热；若应用激素，须根据激素应用不同阶段进行辨证论治。文章最后附医案一则及全文总结。

Abstract:

Professor CHEN Zhiqiang,who has engaged in the treatment and research of kidney diseases for about thirty years,is good at combining traditional Chinese medicine and modern medicine organically together. He accumulated abundant experience in treating chronic kidney disease and put forward a series of valuable clinical academic thoughts. He put forward the new concepts of unchanged pathogenesis and changed pathogenesis creatively. Also,the new concepts have been applied to the treatment of kidney diseases and better clinical effects have been achieved. This article gives an overview of his academic thoughts and clinical experience of treatment on nephrotic syndrome and the following two aspects were included. Firstly,the unchanged pathogenesis and the basic principles of treatment:it is proposed that the basic pathogenesis includes qi and yang deficiency of spleen and kidney as well as retention of dampness and blood stasis. And the basic pathogenesis is called the unchanged pathogenesis by Professor Chen. Also,the principles of treatment includes tonifying qi and yang of spleen and kidney as well as dissipating dampness and activating blood to remove stasis. Secondly,the changed pathogenesis and the principles of treatment:the changed pathogenesis which is called by Professor Chen are affected by the attack of the pathogenic or factors of drug-induced in the process of evolution of nephrotic syndrome. And,the principles of treatment and therapies must correspond with the changed pathogenesis. If the changed pathogenesis includes exogenous wind-cold or wind-heat,the principles of treatment should includes expelling wind-cold or wind-heat respectively. If the patients are treated with hormones,the principles of treatment and therapies must correspond with the concrete phase of hormones therapy and the law of treatment on syndrome differentiation. Also,the last is a medical case and summary.