世界中医药

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。

English Summary:

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 nephritis. 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, meshwork-like tissue theoretically, which is functioning as balance regulation of zang and fu, the pathway of material substance transportation. It plays a crucial role in qi-energizing by means of facilitating water and the essence of grain assimilating, warming and exploring along 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 effective 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 plasma 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 application perspective.

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