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三焦理论与慢性肾炎临床实践

     

摘要

Objective:To investigate different perspectives of the triple-energizer theory , provide guidance for the study of the clinical practice of chronic nephritis , and furthermore clarify the therapeutic mechanism of “smoothing Shaoyang” on the treatment of chronic ne-phritis.Methods:Generalize the characteristics and the essences of the theory of triple-energizer from the angles of three aspects namely the conception , qi-energizing , and its relevance to kidney .By means of the method of “smoothing Shaoyang” that is based on the theory of triple energizer , the anti-nephritis 3rd prescription formula was established and clinical and experimental methodologies were designed as well to investigate its therapeutic mechanism .Results:Triple-energizer (also called Tri-jiao) is presumed as a membranous, mesh-work-like tissue theoretically , which is functioning as balance regulation of zang and fu , the pathway of material substance transporta-tion.It plays a crucial role in qi-energizing by means of facilitating water and the essence of grain assimilating , warming and exploring a-long the pathway , and cleaning the water channel in human body .Almost all of its physiological functions are related closely to kidney;when there is malfunction in the kidney , the basic treatment should be smoothing Shaoyang and mediate triple-energizer .The overall ef-fective percentage for the anti-nephritis 3rd prescription formula is 87%, with the complete remission rate being 32%.At the same time, long term administration of the anti-nephritis 3rd prescription formula can abate urea protein , hematuria, elevate the level of plas-ma protein, participate to regulate immune system , down-regulate the blood lipid and blood pressure , and ameliorate thrombin and blood coagulation.The anti-nephritis 3rd prescription formula has also been observed to alleviate the pathological alterations in the total of four types of animal nephritis , participate in the regulation of cytokine regulating network , and inhibit and reverse the phenotypic transform in renal mesangial cell and tubular mesenchyma cell .As a result, it proved to mitigate nephro-tubular damage and delayed the pathological process of glomerulus sclerosis .Conclusion:The anti-nephritis 3rd prescription formula, which has been proved to be effective in the treatment of nephritis by means of smoothing Shaoyang of triple-energizer, may possess a very valuable scientific importance and applica-tion perspective .%目的:探讨三焦理论,指导慢性肾炎临床实践,验证“疏利少阳”治法的科学依据。方法:从概念、气化、与肾相关性三个方面概述三焦理论;以三焦理论为依据建立疏利少阳治法,组成肾炎3号方,进行慢性肾炎临床及实验研究,并探讨其作机理。结果:理论探讨认为三焦为一膜状、网络状器官组织、是脏腑功能调节和物质输送的主要通路;三焦具有腐熟水谷、温煦开发和决渎水道的气化功能;三焦与肾密切相关,肾脏有病,当疏利少阳、斡旋三焦。疏利少阳标本兼治法之肾炎3号方,治疗慢性肾炎取得总有效率87%、完全缓解率32%的良好疗效。该方具有减少尿蛋白、血尿,提高血浆蛋白,调节免疫,降血脂,降血压,改善高凝状态等作用。实验研究验证了临床疗效,并证实该方能减轻四种不同病理类型肾炎模型的病理损伤,调节细胞因子网络、抑制和逆转系膜细胞、小管-间质细胞的表型转化,减轻肾小管间质损害,减轻和延缓肾小球硬化的病理进程。结论:理论研究和临床实践,证实以疏利少阳三焦为主治疗慢性肾炎的方法,具有重要的科学意义和应用前景。

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