[1]陈茜楠,王自敏,邢海燕.王自敏辨治糖皮质激素在肾脏疾病应用中的不良反应经验[J].陕西中医,2022,(5):632-635.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.021]
　CHEN Qiannan,WANG Zimin,XING Haiyan.WANG Zimin's experience in differentiation and treatment of adverse reactions of glucocorticoids in renal diseases[J].,2022,(5):632-635.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.021]
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王自敏辨治糖皮质激素在肾脏疾病应用中的不良反应经验
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年5期
页码:
632-635
栏目:
名中医经验
出版日期:
2022-05-05

文章信息/Info

Title:
WANG Zimin's experience in differentiation and treatment of adverse reactions of glucocorticoids in renal diseases
作者:
陈茜楠1; 王自敏2; 邢海燕2
(1.河南中医药大学,河南 郑州 450046; 2; 河南中医药大学第一附属医院,河南 郑州 450099)
Author(s):
CHEN Qiannan; WANG Zimin; XING Haiyan
(Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China)
关键词:
糖皮质激素;  不良反应;  肾脏疾病;  辨证论治;  脾肾为本
Keywords:
Glucocorticoid;  Adverse reactions;  Kidney disease;  Syndrome differentiation and treatment;  Spleen and kidney as the basis
分类号:
R 692
DOI:
DOI:10.3969/j.issn.1000-7369.2022.05.021
文献标志码:
A
摘要:
糖皮质激素在肾脏疾病治疗中应用广泛,长期大量使用时,发挥治疗作用的同时会带来较多的不良反应。王自敏教授认为糖皮质激素多具“纯阳”之性,初始及长期使用时,阳热过旺,易伤肾阴,减量阶段,阴损及阳,阴阳两虚,停用阶段,正气亏虚,阳气未复。对于其不良反应的防治,王老主张以分期论治为主,结合患者临床表现不同,适当加减用药,归纳总结三大治疗要点,扶正固本,重在脾肾; 阴阳失调,平补阴阳; 痰瘀内生,化痰祛瘀,提出治疗以“脾肾为本,阴阳为纲,兼顾痰瘀”的学术观点,临床依照此法进行论治,往往能够有效减少不良反应发生率。
Abstract:
Glucocorticoids are widely used in the treatment of kidney diseases.When they are widely used for a long time,they will bring more adverse reactions while playing a therapeutic role.Professor WANG Zimin believes that glucocorticoids mostly have the nature of “pure yang”.During initial and long-term use,excessive yang heat is easy to hurt kidney yin.In the reduction stage,yin and yang are damaged,yin and yang are deficient,and in the discontinuation stage,positive qi is deficient,and yang qi is not restored.For the prevention and treatment of adverse reactions,WANG Zimin advocated that treatment should be based on stages,adding or subtracting drugs appropriately according to the different clinical manifestations of patients,and summarized the three main treatment points,strengthening the foundation,focusing on the spleen and kidney.Imbalance of yin and yang,flat supplement yin and yang; phlegm stasis endogenous,phlegm removal stasis.It puts forward the academic viewpoint of “spleen and kidney as the basis,yin and yang as the main principle,taking into account phlegm and stasis”.Clinical treatment in accordance with this method can often effectively reduce the incidence of adverse reactions.

参考文献/References:

[1] Megerle LS,Naomi S,Ioannis PA.Chronopharmacology of glucocorticoids[J].Advanced Drug Delivery Reviews,2019,152(11):245-261.
[2] 刘娜娜,解凤妮.糖皮质激素对急性重症胰腺炎大鼠肾功能及肠功能的改善作用实验研究[J].陕西医学杂志,2021,50(10):1195-1198.
[3] 刘芬芬,羊 维,黄 琳,等.中医学对糖皮质激素主治功效的药性认识[J].中华中医药杂志,2015,30(4):1268-1270.
[4] Kim JS,Han SY,Iremonger KJ.Stress experience and hormone feedback tune distinct components of hypothalamic CRH neuron activity[J].Nat Commun,2019,10(1):5696.
[5] 王 钰,田占庄.糖皮质激素受体及其调节药物在应激中的作用及机制[J].中国新药与临床杂志,2021,40(4):241-246.
[6] 李爱君,母淑娟,姚 瑶,等.中医对糖皮质激素药理作用理解的探讨[J].山西医药杂志,2018,47(6):700-701.
[7] 刘芬芬,羊 维,黄 琳,等.中医学对糖皮质激素主治功效的药性认识[J].中华中医药杂志,2015,30(4):1268-1270.
[8] 田 丽,张 伟.从少火壮火论浅析中药对糖皮质激素的增效减毒作用[J].长春中医药大学学报,2019,35(1):13-15.
[9] 汪宗清,陈 晨,侯 卫,等.基于“少火生气,壮火食气”理论治疗硬皮病[J].陕西中医,2021,42(4):499-501,513.
[10] 温成平,谢志军.激素不同使用阶段的中医证候诊断和治疗指南[J].中华中医药杂志,2020,35(9):4536-4540.
[11] 曾思敏,梁 琪,韦 静,等.黄贵华从中医学角度论治糖皮质激素不良反应[J].上海中医药杂志,2019,53(7):18-20.
[12] 雷 蕾,熊维建,杨 敬,等.国医大师郑新分期论治糖皮质激素在肾脏疾病应用的不良反应[J].中华中医药杂志,2018,33(1):139-141.
[13] 陈 鑫.从阳气角度论糖皮质激素的作用[J].山东中医杂志,2019,38(8):732-734,739.
[14] 张彦平,贺军涛,殷 鉴,等.尿液免疫球蛋白轻链检测对系统性红斑狼疮肾脏损伤的诊断价值[J].陕西医学杂志,2020,49(9):1172-1174.
[15] 范为民,李 艳.国医大师李济仁教授辨治肾系疾病经验撷要[J].时珍国医国药,2016,27(12):3027-3029.
[16] 张 敏,王自敏,邢海燕.王自敏教授治疗原发性肾病综合征的临床思辨经验[J].浙江中医药大学学报,2021,45(3):244-247,259.
[17] 任玉娇,张 伟.从补肾益气论防治糖皮质激素的不良反应[J].中医杂志,2016,57(15):1345-1347.
[18] 张 擎,张 舒,姚文强,等.运用唐容川“治血四法”辨治糖皮质激素相关性消化道出血[J].江苏中医药,2020,52(11):51-54.
[19] 何才剑,陈天鹏,周 航,等.从“壮火食气”探讨糖皮质激素性骨质疏松症的病机[J].中医杂志,2021,62(14):1273-1275.
[20] 金延强,张 伟.从肺肾相关防治糖皮质激素的副作用[J].陕西中医,2015,36(9):1214-1215.
[21] 齐振强,胡洪贞,李 伟.中医药辨证辅助糖皮质激素治疗肾脏疾病的思路与方法[J].中医杂志,2017,58(20):1736-1739.

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备注/Memo

备注/Memo:
基金项目:河南省中医管理局国家中医临床研究基地科研专项(2018JDZX090); 河南省中医药科学研究专项课题(2017ZY2057)
更新日期/Last Update: 2022-05-09