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1.北京中医药大学,北京 100105
2.首都医科大学附属北京中医医院,北京 100010
Received:30 November 2024,
Published:25 February 2025
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都洁丽,刘宝利,赵启涵,等.基于营卫理论探讨IgA肾病辨治[J].北京中医药,2025,44(2):132-136.
DU Jieli,LIU Baoli,ZHAO Qihan,et al.Differentiation and treatment of IgA nephropathy based on nutrient-defense theory[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(02):132-136.
都洁丽,刘宝利,赵启涵,等.基于营卫理论探讨IgA肾病辨治[J].北京中医药,2025,44(2):132-136. DOI: 10.16025/j.1674-1307.2025.02.004.
DU Jieli,LIU Baoli,ZHAO Qihan,et al.Differentiation and treatment of IgA nephropathy based on nutrient-defense theory[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(02):132-136. DOI: 10.16025/j.1674-1307.2025.02.004.
IgA肾病是我国最为常见的原发性肾小球疾病,IgA肾病的发病多与黏膜免疫相关。本文以营卫理论为基础探析IgA肾病的发病机理,认为营卫失和贯穿IgA肾病始终。其具体机制为营卫失和,外有邪气客伤肌表,卫气失司,营气郁滞,内有脾肾亏虚,营卫生化无源,伏邪藏于营卫之间,气血津液运行失常,内外相合,病理产物蓄积,肾络受损而发为本病。临床治疗提出以调和营卫为基本治法,分期辨治IgA肾病,急性期祛邪为主,疏风祛邪,慢性期扶正为主,温肾健脾,为临床中医药治疗IgA肾病提供新思路。
IgA nephropathy is the most common primary glomerular disease in China, with its onset closely related to mucosal immunity. Based on the nutrient-defense theory, this study explores IgA nephropathy and posits that nutrient-defense disharmony persists throughout the disease course. The specific mechanism involves nutrient-defense imbalance, with external pathogenic
qi
invading the muscular surface, leading to defensive
qi
dysfunction and nutrient qi stagnation. Internally, spleen and kidney deficiency results in the inadequate generation of nutrient and defense, causing hidden pathogens to be trapped between them. This disrupts the normal circulation of
qi
, blood, and body fluids. The interplay of internal and external factors leads to the accumulation of pathological substances, damage to the kidney collaterals, and ultimately the development of the disease. In clinical treatm
ent, harmonizing nutrient and defense is proposed as the fundamental therapeutic principle, with a stage-based differentiation and treatment approach for IgA nephropathy. During the acute phase, the primary strategy is to expel pathogens and facilitate their elimination. In the chronic phase, the focus shifts to strengthening the healthy
qi
by warming the kidneys and invigorating the spleen. This study is expected to provide a novel perspective for the clinical treatment of IgA nephropathy with traditional Chinese medicine.
王海燕 , 赵明辉 . 肾脏病学 [M ] . 北京 : 人民卫生出版社 , 2020 .
RAJASEKARAN A , JULIAN BA , RIZK DV . IgA nephropathy: an interesting autoimmune kidney disease [J ] . Am J Med Sci , 2021 , 361 ( 2 ): 176 - 194 .
艾思南 , 王耀献 , 孙卫卫 , 等 . 王耀献从风湿论治IgA肾病经验 [J ] . 中华中医药杂志 , 2021 , 36 ( 1 ): 236 - 239 .
苗霖之 , 王暴魁 . 风热邪气对IgA肾病与糖尿病肾脏疾病的致病作用探讨 [J ] . 北京中医药 , 2023 , 42 ( 9 ): 1018 - 1020 .
黄敏 , 杜珍芳 , 张红艳 . IgA肾病从风、湿、瘀论治探讨 [J ] . 陕西中医 , 2022 , 43 ( 4 ): 499 - 501 .
夏菲菲 , 刘震超 , 周明爱 , 等 . 近十年营卫学说研究进展 [J ] . 中华中医药杂志 , 2018 , 33 ( 4 ): 1474 - 1477 .
马迎民 , 徐德成 , 范吉平 . 中医“后天之精气培补肾精”的现代医学机制 [J ] . 中医杂志 , 2016 , 57 ( 21 ): 1805 - 1809 .
RAMALHO RRAO M , ZHANG C , et al . Immunometabolism:new insights and lessons from antigen-directed cellular immune responses [J ] . Semin Immunopathol , 2020 , 42 ( 3 ): 279 - 313 .
章恪 . 卫气:免疫细胞的中医表达形式 [J ] . 湖北中医杂志 , 2001 ( 3 ): 3 - 4 .
刘啸 , 祝彼得 , 冯雪梅 , 等 . 从造血与免疫的关系探讨营卫本质及交会机理 [J ] . 甘肃中医学院学报 , 2005 ,( 3 ): 11 - 13 .
廖世忠 . 玉屏风散防止易感者探讨其“卫气”与免疫球蛋白的关系 [J ] . 辽宁中医杂志 , 1993 , 19 ( 11 ): 35 .
夏菲菲 . 中医卫气与西医免疫的比较研究 [D ] . 青岛 : 青岛大学 , 2019 .
SUZUKI H , KIRYLUK K , NOVAK J , et al . The pathophysiology of IgA nephropathy [J ] . J Am Soc Nephrol , 2011 , 22 ( 10 ): 1795 - 1803 .
邓钦华 , 邹迪 , 张守琳 , 等 . 中医药调控黏膜免疫治疗IgA肾病研究进展 [J/OL ] . 中医学报 , 1 - 7 [ 2024-11-28 ] . http://kns.cnki.net/kcms/detail/41.1411.R.20241128.0954.010.html http://kns.cnki.net/kcms/detail/41.1411.R.20241128.0954.010.html .
ZHANG H , DENG Z , WANG Y . Molecular insight in intrarenal inflammation affecting four main types of cells in nephrons in IgA nephropathy [J ] . Front Med , 2023 , 10 : 1128393 .
赵洁 , 史伟 , 樊均明 , 等 . 从伏邪论治IgA肾病的理论探讨 [J ] . 中华中医药杂志 , 2019 , 34 ( 10 ): 4709 - 4712 .
NIHEI Y , SUZUKI H , SUZUKI Y . Current understanding of IgA antibodies in the pathogenesis of IgA nephropathy [J ] . Front Immunol , 2023 , 14 : 1165394 .
卓小玉 , 陈晶 , 田明 , 等 . 麻黄的化学成分与药理作用研究进展 [J ] . 中医药信息 , 2021 , 38 ( 2 ): 80 - 83 .
赵佩媛 , 韩立柱 , 汪芸兰 , 等 . 连翘的研究进展及质量标志物的预测分析 [J ] . 中华中医药学刊 , 2022 , 40 ( 4 ): 19 - 27 .
杨晰雯 , 胡文凯 , 蒋鑫 , 等 . 柴胡化学成分及药理作用研究进展 [J ] . 药学前沿 , 2024 , 28 ( 11 ): 507 - 522 .
李伟 , 徐伟 . 黄芩苷药理作用研究进展 [J ] . 中西医结合研究 , 2022 , 14 ( 3 ): 193 - 196 .
王宪 , 刘金星 , 刘桂荣 . 麻黄的“破癥坚积聚”功效分析 [J ] . 中国实验方剂学杂志 , 2017 , 23 ( 19 ): 207 - 211 .
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