饶向荣辨治特发性膜性肾病并发急性肾损伤经验

张南南; 饶向荣

doi:10.16025/j.1674-1307.2025.06.017

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饶向荣辨治特发性膜性肾病并发急性肾损伤经验

学验传承 | 更新时间：2025-08-04

- 饶向荣辨治特发性膜性肾病并发急性肾损伤经验
- RAO Xiangrong's experience in diagnosis and treatment of idiopathic membranous nephropathy complicated with acute kidney injury
- 北京中医药 2025年44卷第6期页码：751-753
- 作者机构：
  
  1.北京中医药大学房山医院肾病科，北京 102400
  2.中国中医科学院广安门医院，北京 100053
- 作者简介：
  
  张南南，女，40岁，硕士，副主任医师。研究方向：中西医结合防治慢性肾脏病。
  饶向荣，E-mail： raoyisheng@163.com
- 基金信息：
  
  第七批全国老中医药专家学术经验继承工作项目(国中医药人教函〔2022〕76号)
- DOI：10.16025/j.1674-1307.2025.06.017
  中图分类号：
- 收稿日期：2024-04-21，
  
  纸质出版日期：2025-06-25
- 稿件说明：
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张南南，饶向荣.饶向荣辨治特发性膜性肾病并发急性肾损伤经验［J］.北京中医药，2025，44（6）：751-753.

ZHANG Nannan,RAO Xiangrong.RAO Xiangrong's experience in diagnosis and treatment of idiopathic membranous nephropathy complicated with acute kidney injury[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(06):751-753.
张南南，饶向荣.饶向荣辨治特发性膜性肾病并发急性肾损伤经验［J］.北京中医药，2025，44（6）：751-753. DOI： 10.16025/j.1674-1307.2025.06.017.

ZHANG Nannan,RAO Xiangrong.RAO Xiangrong's experience in diagnosis and treatment of idiopathic membranous nephropathy complicated with acute kidney injury[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(06):751-753. DOI： 10.16025/j.1674-1307.2025.06.017.

摘要

特发性膜性肾病（IMN）并发急性肾损伤（AKI）的机制复杂，且涉及众多因素。饶向荣教授结合临床经验，认为IMN并发AKI的病机特点为本虚标实，脾肾不足，湿瘀交阻。治疗应首辨三焦病变轻重，采用治上焦宜通、治中焦宜和、治下焦宜下的治法，补虚、活血、利湿贯穿始终，常需和解，以平为期。治疗中分清轻重缓急，中西结合综合治疗，提高临床疗效，减少临床终点事件的发生。

Abstract

The pathogenesis of idiopathic membranous nephropathy （IMN） complicated with acute kidney injury （AKI） is complex and involves multiple factors. Based on clinical experience， professor RAO Xiangrong believes that the pathogenesis of IMN complicated with AKI is characterized by deficiency of the root and excess of the manifestation， spleen and kidney insufficiency， and obstruction caused by dampness and blood stasis. Treatment should first differentiate the severity of lesions in the triple energizerand adopt the principles of treating the upper energizer with dredging， harmonizing the middle energizer， and directing the lower energizer downward. Tonifying deficiency， activating blood circulation， and promoting diuresis should be applied throughout the treatment， with frequent emphasis on reconciliation and maintaining balance. It is important to distinguish the severity and urgency during treatment. Integrating traditional Chinese and western medicine can improve clinical efficacy and reduce the occurrence of clinical endpoint events.

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references

CATTRAN DC , BRENCHLEY PE . Membranous nephropathy: integrating basic science into improved clinical management [J ] . Kidney Int , 2017 , 91 ( 3 ): 566 - 574 .

XU X , WANG G , CHEN N , et al . Long-term exposure to air pollution and increased risk of membranous nephropathy in China [J ] . J Am Soc Nephrol , 2016 , 27 ( 12 ): 3739 - 3746 .

LI Z , WENG M , LIN L , et al . Acute kidney injury in patients with idiopathic membranous nephropathy: influencing factors and prognosis [J ] . Ren Fail , 2023 , 45 ( 1 ): 2194451 .

CHEN T , ZHOU Y , CHEN X , et al . Acute kidney injury in idiopathic membranous nephropathy with nephrotic syndrome [J ] . Ren Fail , 2021 , 43 ( 1 ): 1004 - 1011 .

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郭传 , 饶向荣 . 对中医治疗膜性肾病的几点思考 [J ] . 北京中医药 , 2018 , 37 ( 7 ): 635 - 638 .

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刘宝利 , 赵进喜 , 刘玉宁等 . 论膜性肾病的中医概念与中医药治疗 [J ] . 北京中医药 , 2019 , 38 ( 3 ): 195 - 199 .

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