益气养阴祛瘀法治疗IgA肾病机理浅探
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摘要
IgA肾病是世界范围内最常见的原发性肾小球疾病,是导致终末期肾脏病的主要因素之一。中医学认为,IgA肾病核心病机为正虚邪实,本虚以气阴两虚为主,邪实以血瘀、湿热多见,益气养阴祛瘀法为IgA肾病的主要治法。笔者就益气养阴祛瘀法治疗IgA肾病的中医理论依据及现代实验室机制进行了探讨分析,可为临床治疗本病提供参考。
IgA nephropathy,the most common primary glomerular disease worldwide,is one of the main factors leading to end-stage renal disease. According to Chinese medicine,the core pathogenesis of IgA nephropathy is vital qi-deficiency and evil-excess,the former often manifests as qi-yin deficiency while the latter as blood stasis and dampness-heat,and the main method of treatment for IgA nephropathy was the method of invigorating qi,nourishing yin and resolving stasis. The author discussed and analyzed the theoretical basis in Chinese medicine and modern laboratory mechanism in terms of the method of invigorating qi,nourishing yin and resolving stasis for IgA nephropathy,thus to provide reference for the clinical treatment for this disease.
IgA nephropathy,the most common primary glomerular disease worldwide,is one of the main factors leading to end-stage renal disease. According to Chinese medicine,the core pathogenesis of IgA nephropathy is vital qi-deficiency and evil-excess,the former often manifests as qi-yin deficiency while the latter as blood stasis and dampness-heat,and the main method of treatment for IgA nephropathy was the method of invigorating qi,nourishing yin and resolving stasis. The author discussed and analyzed the theoretical basis in Chinese medicine and modern laboratory mechanism in terms of the method of invigorating qi,nourishing yin and resolving stasis for IgA nephropathy,thus to provide reference for the clinical treatment for this disease.
引文
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[8]万廷信,戴恩来,王文革,等.Ig A肾病中医邪实证候与靶器官病理特征的相关性研究[J].中国中西医结合杂志,2015,35(9):1044-1049.
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[10]陈红波,庄英,马红珍,等.参芪地黄汤对Ig A肾病大鼠肾组织nephrin、podocin蛋白及其m RNA表达的影响[J].中医杂志,2013,54(7):601-604.
[11]Meng XM,Tang MK,Li J,et al.TGF-β/Smad signaling in renal fibrosis[J].Front Physiol,2015,6:82.
[12]Lópezhernández FJ,Lópeznovoa JM.Role of TGF-βin chronic kidney disease:an integration of tubular,glomerular and vascular effects[J].Cell&Tissue Research,2012,347(1):141-154.
[13]高辉,汪涛,余仁欢,等.以加味参芪地黄汤为主延缓慢性肾功能衰竭进展的队列研究[J].中国中西医结合杂志,2012,32(1):39-42.
[14]鲁科达,谢志军,马红珍,等.消瘀泄浊饮对单侧输尿管梗阻大鼠肾组织TGF-β_1表达的影响[J].中国中西医结合肾病杂志,2011,12(8):665-668,753.
[15]鲁科达,张冰冰,张培培,等.消瘀泄浊饮对慢性肾衰竭营养不良大鼠残肾组织保护作用机制研究[J].浙江中医药大学学报,2016,40(2):137-142.
[16]鲁科达,张冰冰,张培培,等.消瘀泄浊饮对慢性肾衰竭营养不良大鼠骨骼肌组织UPP组分表达的影响[J].中华中医药学刊,2017,35(3):635-638.
[2]Lai KN.Pathogenesis of Ig A nephropathy[J].Nat Rev Nephrol,2012,8(5):275-83.
[3]马红珍,陈红波,何灵芝,等.加减参芪地黄汤治疗Ig A肾病“气阴两虚”证临床疗效观察[J].浙江中医药大学学报,2012,36(5):491-493,496.
[4]鲁科达,邵明祥,马红珍,等.消瘀泄浊饮治疗慢性肾脏病气虚夹瘀证临床疗效观察[J].浙江中医药大学学报,2014,38(6):718-721.
[5]陈香美,陈以平,李平,等.1016例Ig A肾病患者中医证候的多中心流行病学调查及相关因素分析[J].中国中西医结合杂志,2006,26(3):197-201.
[6]孙建实.Ig A肾病中医病因病机新探[J].中医药学报,2006,34(2):1-2.
[7]聂莉芳.Ig A肾病中医病名、证候特点及益气滋肾治法研究[J].中国中西医结合肾病杂志,2015,16(1):1-3.
[8]万廷信,戴恩来,王文革,等.Ig A肾病中医邪实证候与靶器官病理特征的相关性研究[J].中国中西医结合杂志,2015,35(9):1044-1049.
[9]Ji L,Chen X,Zhong X,et al.Astragalus membranaceus up-regulate Cosmc expression and reverse Ig A dys-glycosylation in Ig A nephropathy[J].BMC Complement Altern Med,2014,14:195.
[10]陈红波,庄英,马红珍,等.参芪地黄汤对Ig A肾病大鼠肾组织nephrin、podocin蛋白及其m RNA表达的影响[J].中医杂志,2013,54(7):601-604.
[11]Meng XM,Tang MK,Li J,et al.TGF-β/Smad signaling in renal fibrosis[J].Front Physiol,2015,6:82.
[12]Lópezhernández FJ,Lópeznovoa JM.Role of TGF-βin chronic kidney disease:an integration of tubular,glomerular and vascular effects[J].Cell&Tissue Research,2012,347(1):141-154.
[13]高辉,汪涛,余仁欢,等.以加味参芪地黄汤为主延缓慢性肾功能衰竭进展的队列研究[J].中国中西医结合杂志,2012,32(1):39-42.
[14]鲁科达,谢志军,马红珍,等.消瘀泄浊饮对单侧输尿管梗阻大鼠肾组织TGF-β_1表达的影响[J].中国中西医结合肾病杂志,2011,12(8):665-668,753.
[15]鲁科达,张冰冰,张培培,等.消瘀泄浊饮对慢性肾衰竭营养不良大鼠残肾组织保护作用机制研究[J].浙江中医药大学学报,2016,40(2):137-142.
[16]鲁科达,张冰冰,张培培,等.消瘀泄浊饮对慢性肾衰竭营养不良大鼠骨骼肌组织UPP组分表达的影响[J].中华中医药学刊,2017,35(3):635-638.