难治性肾病综合征中医病机篡要

摘要

RNS is extremely common in clinic, belonging to Chinese “edema”, “refined gas discharged”, “wasting”category, and it is a kind of kidney disease with current difficult clinical treatment and poor prognosis. In recent years, TCM understanding of its pathogenesis main includes zheng xu (Qi, blood, Yin and Yang), and/or biao shi (rheumatic fever and phlegm stasis toxin). This study analyzes and summarizes research status pathogenesis based on the patho-physiology different angles of TCM organs, meridians, Yin and Yang, blood and body fluids, in the sick evil. Meantime, the author believes that, RNS pathogenesis should be explained by means of immune pathology biopsy, and the renal pathological histology is as an extension of traditional Chinese medicine inspection, and it is given new meaning to ex-plain purpose. This may be another way to further understand the cause and pathogenesis of RNS.%难治性肾病综合征(RNS)临床极为常见，属中医“水肿”、“精气下泄”、“虚损”范畴，是目前临床治疗比较棘手、预后较差的肾病。近年来中医对其病因病机认识主要包括正虚(气血阴阳)和/或标实(风湿热痰瘀毒)。本文从中医脏腑、经络、阴阳、气血津液、内生病邪等不同病理生理学角度分析归纳了RNS中医病因病机研究现状。同时，笔者认为阐释RNS的中医病机应借助于肾活检免疫病理学检查，将肾脏病理组织学表现作为中医望诊之延伸，并赋予新义，阐释经旨；这或是进一步认清RNS中医病因病机的又一途径。