应用阴阳平衡理论、肾小管-肾小球反馈理论指导临床治疗小管-间质肾病肾衰83例

Summary Report on the Treatment of Tubulo-lnterstitial Nephropathy,Renal Failure with TCM-WM under the Guidance of Yin-Yang Balance Theory and Tubulo-Glomerular Feedback Theory—A Clinical Analysis of 83 Cases

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中文关键词: 平衡理论肾小管间质病变抗高血压药物中医治法中西医结合肾病肾损害水电解质紊乱肾性高血压间质性

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作者	单位
卢君健	苏州医学院附属一院中西医结合研究室
潘肇荣	苏州医学院附属一院动物实验室
周自强	苏州医学院附属一院临床中西医实验室
钱起	苏州医学院附属一院临床中西医实验室
崔肖范	苏州医学院附属一院中西医结合研究室
李文彩	苏州医学院附属一院中西医结合研究室

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中文摘要:

本文报道83例与肾小管间质病变有关的肾病肾衰,并应用阴阳平衡理论结合肾小管-肾小球反馈理论及其他理论指导治疗上述疾病。中医治法有滋阴生津、活血、益气、清热、健脾等法,西药仅用抗高血压药物及输液补充电解质。结果83例治愈者占10.8%,总有效率为80.7%。

英文摘要:

Attention has recently been drawn to the significance of tubulo-interstitial lesions in acute and chronic renal failure（RF）.The importance of tubulo-interstitial lesion for some RF patients by means of comprehensive evaluating the urine concentration of β₂ microglobin（β₂m）,clinical manifestations and other laboratory tests have been defined.Hence using the therapy of TCM combined with the tubulo-glomerular feedback theory,Yin-Yang balance theory,i.e.couple imbalance theory and"five differentiation"theory of TCM-WM,a preliminary result of treating 83 cases of this disease has been obtained.Among them,9 were cured;the cure rate was 10.8%,and total effective rate was 80.7%（67 cases）,while 16 of them were noneffective（19.3%）.The main causes of tubulo-interstitial lesion are as follows:（1）Infection and /or disturbance of water and electrolyte metabolism,43.4%.（2）Various drugs including antibiotics and analgesics and reflux nephropathy,25.2%.（3）Secondary interstitial impairment,e.g.renal arteriosclerosis, hyperuricemia,etc.,induced by nephropathy,16.8%.（4）Secondary interstitial lesions caused by systemic disease,e.g.SLE,14.6%.Comparing the therapeutic effect between these 4 groups,it shows that the effect of the first group is better than that of others,the hospitalization period being the shortest among all,but no significant difference of effective rate was observed.The treatment was based on the guidance of the above-mentioned theories.Western medicines were used only for antihypertension and correcting the disturbances of water and electrolyte metabolism by proper parenteral replacement.TCM methods such as "nourish vital essence,strengthen vital energy,expel evil-wind,clear up heat,promote blood circulation, warm kidney,invigorate spleen,promote production of body fluid",etc.were used according to the morbid condition and mechanism of disease.The materia medica frequently used were R.Puerariae lobata,Fr. Prunus mume,R.Saposhnikovia divaricata,R.Rehmanniae glutinosa,R.Glycyrrhizae uralensis,R. Cynanchi paniculati and R.Scutellariae baicalensis,etc.The dosage varied according to the morbid state.

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