海派名医童少伯论治慢性肾脏病经验撷萃(1)
[摘要] 童少伯为全国名中医，上海丁氏内科流派传人。童老在长期临床工作中，提出了治疗肾脏病应掌握以下要点：第一，和调阴阳，肺脾肾三脏兼顾；第二，注重表里，上中下三焦通调；第三，扶正祛邪，补调泻三法共用。童老认为慢性肾脏病乃本虚标实之证，多为虚实夹杂，尤以脾肾亏虚为本，继而出现水湿、痰浊、血瘀等实邪，这些实邪继续作用于机体，影响机体功能失常，病情迁延，反复发作难愈。因此童老论治慢性肾脏病，常常兼顾肺脾肾三脏，注重阴阳表里的调和，扶助正气的同时，兼顾邪实，制订了一系列治法治则，多法联用，随证治之。
[关键词] 童少伯；慢性肾脏病；病因病机；辨证论治
[中图分类号] R243 [文献标识码] A [文章编号] 1673-7210(2018)11(c)-0098-05
Experience of treating chronic kidney diseases from the Shanghai style famous doctor TONG Shaobo
WANG Jie CHEN Wenhao SUN Beibei JI Jing LI Yuting YU Hongji HE Liqun
Department of Nephrology， Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， Shanghai 200021， China
[Abstract] TONG Shaobo is a famous doctor of Chinese medicine and the successor of Ding′s internal medicine of Shanghai. In the long term clinical work， TONG Shaobo proposes to grasp the following key points in treating chronic kidney disease： Firstly， it is important to adjust the Yin and Yang， and give consideration of the lung， spleen and kidney. Secondly， the outside and the inside of body should be paid attention to， and adjust the tri-jiao. Thirdly， it is essential to strengthen the body resistance to eliminate pathogenic factors. TONG Shaobo believes that chronic kidney disease is the evidence of the deficiency， most of which are integrated false and solid， especially the deficiency of the spleen and kidney is the basis， leading to the damp wet， phlegm， blood stasis and other solid pathogenic factors. These factors will in turn lead to the dysfunction of the body， and which is difficult to be cured. Therefore， TONG Shaobo formulates a series of rules of treatment， taking into account the three organs-lung， spleen and kidney， paying attention to the harmonization of Yin and Yang. His treating rules not only helps the positive Qi， but also takes into account the existence of the pathogenic factors. He formula a series of therapies and rules in treatment， and uses multiple methods according to different syndrome differentiation.
[Key words] TONG Shaobo； Chronic kidney disease； Etiology and pathogenesis； Syndrome differentiation
慢性腎脏病(chronic kidney disease，CKD)是指各种原因引起的肾损害≥3个月(包括肾脏结构或功能异常)，有或无肾小球滤过率(GFR)降低；或GFR<60 mL/(min·1.73 m2)>3个月。CKD因患病率高、危害性大而越来越受到人们的重视。美国成人的CKD患病率高达14%[1]。澳大利亚≥25岁的成人中约有1/7为CKD患者[2]。我国的CKD发病率高达10.8%，约有1.195亿人罹患该病[2]。从国内外的数据来看，慢性非传染性疾病己成为全球公共卫生问题，也是我国而临的主要健康问题。
童少伯，祖籍江苏，沪上名医，自幼酷好学医，熟读四书五经，文学功底深厚，后师从申城名医丁氏内科流派丁继万教授，学习中医，熟读《内经》《伤寒》《金匮》等古典医籍，深谙中医理论精髓，曾任上海中医专门学校教授，一边教书育人，一边投身临床，运用所学经典理论，治病救人。童老不断研习中医的同时，还积极学习现代医学知识和现代医学检查技术手段，中西汇通，善治内科多种病症，在呼吸系统、心血管系统、脾胃消化系统以及泌尿系统等方面都有建树，其弟子桃李满天下，传承人遍及心肺、脾胃、肾脏各科，现将童老治疗慢性肾病的经验和治学特点归纳如下：, 百拇医药(王杰 陈文浩 孙蓓蓓)
[关键词] 童少伯；慢性肾脏病；病因病机；辨证论治
[中图分类号] R243 [文献标识码] A [文章编号] 1673-7210(2018)11(c)-0098-05
Experience of treating chronic kidney diseases from the Shanghai style famous doctor TONG Shaobo
WANG Jie CHEN Wenhao SUN Beibei JI Jing LI Yuting YU Hongji HE Liqun
Department of Nephrology， Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， Shanghai 200021， China
[Abstract] TONG Shaobo is a famous doctor of Chinese medicine and the successor of Ding′s internal medicine of Shanghai. In the long term clinical work， TONG Shaobo proposes to grasp the following key points in treating chronic kidney disease： Firstly， it is important to adjust the Yin and Yang， and give consideration of the lung， spleen and kidney. Secondly， the outside and the inside of body should be paid attention to， and adjust the tri-jiao. Thirdly， it is essential to strengthen the body resistance to eliminate pathogenic factors. TONG Shaobo believes that chronic kidney disease is the evidence of the deficiency， most of which are integrated false and solid， especially the deficiency of the spleen and kidney is the basis， leading to the damp wet， phlegm， blood stasis and other solid pathogenic factors. These factors will in turn lead to the dysfunction of the body， and which is difficult to be cured. Therefore， TONG Shaobo formulates a series of rules of treatment， taking into account the three organs-lung， spleen and kidney， paying attention to the harmonization of Yin and Yang. His treating rules not only helps the positive Qi， but also takes into account the existence of the pathogenic factors. He formula a series of therapies and rules in treatment， and uses multiple methods according to different syndrome differentiation.
[Key words] TONG Shaobo； Chronic kidney disease； Etiology and pathogenesis； Syndrome differentiation
慢性腎脏病(chronic kidney disease，CKD)是指各种原因引起的肾损害≥3个月(包括肾脏结构或功能异常)，有或无肾小球滤过率(GFR)降低；或GFR<60 mL/(min·1.73 m2)>3个月。CKD因患病率高、危害性大而越来越受到人们的重视。美国成人的CKD患病率高达14%[1]。澳大利亚≥25岁的成人中约有1/7为CKD患者[2]。我国的CKD发病率高达10.8%，约有1.195亿人罹患该病[2]。从国内外的数据来看，慢性非传染性疾病己成为全球公共卫生问题，也是我国而临的主要健康问题。
童少伯，祖籍江苏，沪上名医，自幼酷好学医，熟读四书五经，文学功底深厚，后师从申城名医丁氏内科流派丁继万教授，学习中医，熟读《内经》《伤寒》《金匮》等古典医籍，深谙中医理论精髓，曾任上海中医专门学校教授，一边教书育人，一边投身临床，运用所学经典理论，治病救人。童老不断研习中医的同时，还积极学习现代医学知识和现代医学检查技术手段，中西汇通，善治内科多种病症，在呼吸系统、心血管系统、脾胃消化系统以及泌尿系统等方面都有建树，其弟子桃李满天下，传承人遍及心肺、脾胃、肾脏各科，现将童老治疗慢性肾病的经验和治学特点归纳如下：, 百拇医药(王杰 陈文浩 孙蓓蓓)