何学红教授中医药辨治肾性血尿经验总结

发布时间：2018-03-13 09:37

本文选题：肾性血尿　切入点：中医药辨治　出处：《辽宁中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：肾性血尿是指血尿源于肾小球,可见于原发或继发性肾小球疾病,可隐匿起病,不易发现,且病程迁延,易于复发。根据肾性血尿特点将其归为中医的“尿血”范畴,早在《黄帝内经》中就有关于本病的记载,《素问》中称之为“溲血”、“溺血”。导师何学红根据三十余年临床经验与自身体悟,运用中医辨证论治体系,针对不同证型肾性血尿患者因证立法,依法选方,随症加减,屡有效验。她认为肾性血尿的发生病位虽在肾与膀胱,但与心肝脾肺关系密切,因血液生化于脾,藏于肝,统于心,上输于肺,化精于肾,脉为血液运行的通道,任一脏受邪均可致血溢脉外,而发生血尿。本病病理性质属本虚标实,或虚实夹杂。虚者多为脾肾两虚或肾阴亏虚,实者多为外受风热或湿热之邪,虚实夹杂者因病情迁延反复发作,因实致虚,因虚致瘀,而致虚实夹杂。所以导师在本病的辨证分型上根据感邪轻重和脏腑虚实的不同,从邪实、正虚、虚实夹杂三方面辨证施治。邪实者分为:风热袭肺、心营热盛、脾虚湿盛、肝火上炎、膀胱湿热;正虚者分为:阴虚火旺、脾不统血、脾肾气阴两虚;虚实夹杂者为瘀血内阻。治疗上邪实者宜祛邪为主,兼凉血止血;正虚者宜扶正为主,兼凉血化瘀止血;虚实夹杂者宜化瘀为主,兼扶正。导师自创具有益气养阴,凉血止血功效的验方——降血丹,针对脾肾气阴两虚型血尿患者颇有效验。除药物治疗外,导师还强调病后的预防与调护的重要性,体现了中医“未病先防,既病防变”的特点。
[Abstract]:Renal hematuria is defined as hematuria derived from glomeruli, which can be seen in primary or secondary glomerular diseases, which can be concealed and difficult to find, and the course of disease is prolonged and easy to recur. According to the characteristics of renal hematuria, it is classified as "urine blood" in traditional Chinese medicine. As early as the Yellow Emperor's Internal Classic, there is a record of this disease, which is called "Deutzia blood" and "blood drowning" in Su-Quan. According to more than 30 years of clinical experience and his own understanding, his mentor he Xuehong used the system of syndrome differentiation and treatment of TCM. For patients with different syndromes of renal hematuria, according to the law, the prescription is selected according to the law, and it is added or subtracted with the syndrome, and it is often effective. She thinks that although the occurrence of renal hematuria is located in the kidney and bladder, it is closely related to the heart, liver, spleen and lung, because the blood is biochemical in the spleen and hidden in the liver. In the heart, in the lung, in the lung, in the kidney, in the kidney, and in the blood channel, any visceral evil can cause the blood to overflow outside the vein, and the hematuria occurs. The pathological nature of the disease belongs to the original deficiency standard solid, or the deficiency of the deficiency. The deficiency is mostly the deficiency of spleen and kidney, or the deficiency of kidney yin, and the pathological nature of the disease is the deficiency of both spleen and kidney, or the deficiency of kidney and yin. Most of them are caused by wind heat or damp-heat evil outside, and those with deficiency and solid have repeated attacks due to the prolongation of the illness, and the deficiency and stasis are caused by the deficiency. Therefore, the teacher's syndrome differentiation and classification of the disease is based on the different degrees of the sense of evil and the deficiency of the viscera, and the difference of the deficiency of the viscera and the internal organs. It is divided into three aspects: wind and heat attack lung, heart heat, spleen deficiency dampness, liver-fire inflammation, bladder damp-heat, deficiency of Yin fire, spleen not regulating blood, spleen and kidney qi and yin deficiency; the former is divided into three aspects: wind and heat attack on lung, spleen deficiency dampness Sheng, liver fire inflammation, bladder dampness and heat, and deficiency of Yin and deficiency of spleen and kidney qi and yin, and deficiency of spleen and kidney qi and yin. The internal obstruction of blood stasis is the inclusion of deficiency and solid. It is advisable to dispel pathogenic factors and cool blood to stop bleeding in the treatment of upper evil and excess. In the case of positive deficiency, it is appropriate to strengthen the positive, and to cool the blood and remove blood stasis to stop the bleeding. In the case of deficiency and solid, it is appropriate to remove the blood stasis as the main factor, and to strengthen the health. The test prescription of cooling blood and hemostasis-Jiangxue Dan, is quite effective for blood and urine patients with deficiency of spleen and kidney qi and yin. In addition to drug treatment, the tutor also emphasizes the importance of prevention and nursing after illness, which reflects the characteristics of Chinese medicine "preventing disease before illness, preventing disease from changing".
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R277.5

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