浅谈陈志强教授“消坚固本法”治疗多囊肾经验

Professor CHEN Zhiqiang's experience in treating polycystic kidney with the method of “Xiaojian Guben”

关键词:  陈志强  多囊肾  攻补兼施  调和升降  虫类药  对药  宣通三焦  消坚固本

Key words:  CHEN Zhiqiang  polycystic kidney disease  combination of attack and supplement  adjust the qi movement  insect medicine  drug pair  Xuantong Sanjiao  Xiaojian Guben

摘要:

多囊肾是一种遗传性肾囊肿类疾病，陈志强教授认为此病多是由于先天禀赋不足，体质差异，致使肾、肝、脾功能失调，气滞、湿阻、痰凝、血瘀为患，渐成癥积，进而发为囊肿，故其初期病机为脾肾亏虚、肝郁气滞、痰瘀互结；该病病情日久，肾体衰惫，痰湿更甚，浊毒内停，弥漫三焦，病机进展为:脾肾亏虚，血瘀浊毒内蕴。在治疗上，以“消坚固本”为原则，同时根据疾病不同时期的病机采取相应的治疗方法，初期应攻补兼施，即扶正祛邪兼顾，常用黄芪以培补正气，补肾健脾，浙贝母、三棱、莪术等药以消癥祛邪，同时以柴胡、木香、乌药、麸炒枳壳、炒莱菔子等药调和气机升降，善于应用地龙、水蛭、鳖甲、牡蛎等虫类药以逐瘀散结，适时加用如红藤-败酱草、三七粉-仙鹤草、生地黄-牡丹皮等对药以治疗相应兼症；后期通过宣通上、中、下三焦治法以增强祛湿泄浊解毒之功，同时结合现代医学的治疗特点，中西结合，中西合璧以缓解病情，改善症状，提高患者生存质量。

Abstract:

Polycystic kidney is a hereditary renal cyst disease. Professor CHEN Zhiqiang believes that the disease is mostly due to congenital deficiency and physical differences,resulting in dysfunction of kidney,liver and spleen. Qi stagnation,dampness resistance,phlegm coagulation and blood stasis are the causes of the disease,which gradually leads to the accumulation of symptoms and then to cysts. Therefore,the initial pathogenesis is deficiency of spleen and kidney,stagnation of liver qi,combination of phlegm and blood stasis. The disease lasts for a long time,with kidney failure,phlegm and dampness advancing,turbid toxin blocking inside,Sanjiao diffusing,which pathogenesis progress is deficiency of spleen and kidney,blood stasis and turbid toxin blocking inside. Therefore,in the treatment,it is necessary to use the method of "Xiaojian Guben" and takes corresponding treatment measures according to the pathogenesis of the disease in different periods. At the initial stage,both attack and supplement should be applied,that is strengthening body resistance and eliminating evil. Astragalus membranaceus is commonly used to nourish vital qi,tonify kidney and spleen, fritillariae thunbergii bulbus,Sparganium,zedoary turmeric and other drugs to dispel disease and evil. At the same time,it should be mixed with bupleurum,guangmuxiang,black medicine,stir fried Fructus aurantii,stir fried semen Raphani and other drugs to adjust the qi movement. It should be good at using pheretima,hirudo,trionycis carapax,ostreae concha and other insect drugs to dispel stasis,dispel stasis and eliminate disease. It should be added in time,such as red rattan-Patrinia,Panax Notoginseng powder-Agrimonia,and rehmanniae radix-moutan cortex to treat the corresponding concurrent disease. At later stage,the function of removing dampness and turbidity and detoxification can be enhanced through the treatment of upper,middle and lower Sanjiao. At the same time,combined with the treatment characteristics of modern medicine,the integrated treatment of Chinese and Western medicine can alleviate the disease,improve the symptoms and the quality of life of patients.