首页|王雪峰教授治疗儿童难治性肾病综合征合并特应性皮炎经验探析

王雪峰教授治疗儿童难治性肾病综合征合并特应性皮炎经验探析

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难治性肾病综合征治疗困难、复发率高,现代研究发现患者多伴有外周血总IgE升高,与特应性疾病有很多相似之处,推测二者在发病机制、细胞因子改变等方面存在相似性,难治性肾病合并特应性皮炎者临床治疗更为棘手.王雪峰教授根据《黄帝内经》理论,提出难治性肾病激素疗法中会逐步出现"壮火内盛""壮火食气"及"少火不足"三个阶段,认为激素依赖型肾病及频复发型肾病的病机关键是"壮火食气",而本病治疗的重点是维持少火生气的功能,减少"壮火食气"的副作用,从而防止激素依赖及频复发.同时指出,难治性肾病合并特应性皮炎者不同于普通疮疖,此乃阴虚结毒,体虚邪盛,渍后毒未去而阴益伤,故病难已.治疗上强调根据肾病的不同阶段处方用药,同时注重益气养阴,临床每获良效.
Professor Wang Xuefengs experience in treating refractory nephritic syndrome combined with atopic dermatitis in children
Refractory nephrotic syndrome(RNS)is difficult to treat and has a high recurrence rate.Modern research has found that patients are often accompanied by an increase in total IgE in peripheral blood,which has many similarities with atopic diseases.It is speculated that the pathogenesis and cytokine changes are similar between RNS and atopic dermatitis(AD).The clinical treatment for RNS combined with AD is more challenging.Professor Wang Xuefeng,based on the theory of the Huangdi Inner Canon,proposes that there are three phases of"powerful fire inside","powerful fire consuming qi"and"junior fire insufficiency"in the corticosteroid therapy for RNS.She believes that the key pathogenesis of steroid-dependent(SDNS)and frequently relapsing nephrotic syndrome(FRNS)is"powerful fire consuming qi",and the focus in the treatment of SDNS/FRNS is to maintain the function of junior fire generating qi,and to reduce the side effects of"powerfulfire consuming qi",so as to prevent steroid dependence and frequent recurrence.Also,RNS combined with AD is different from common sores and furuncles;it is Yin deficiency,body weakness and toxin strength.After the lesion is removed,the toxin has not gone and Yin becomes less,so the disease is difficult to heal.Professor Wang Xuefeng emphasizes that different medications should be used for different stages of NS,and she pays attention to Qi nourishing and Yin nourishing,which had a good clinical effect.

Refractory nephrotic syndromeAtopic dermatitisSteroid-dependent nephrotic syndromeFrequently relapsing nephrotic syndromeJunior firePowerful fireFamous doctors experience

沈小钰、王翠锦、吴燕、殷蕾、孙克兴、沙莎、王雪峰

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200127 上海,上海交通大学医学院附属上海儿童医学中心肾脏内科

200127 上海,上海交通大学医学院附属上海儿童医学中心神经内科

200127 上海,上海交通大学医学院附属上海儿童医学中心国际诊疗部

200127 上海,上海交通大学医学院附属上海儿童医学中心中医科

110032 沈阳,辽宁中医药大学附属医院儿科

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难治性肾病 特应性皮炎 激素依赖型肾病 频复发型肾病 少火 壮火 名医经验

上海市综合医院中西医结合专项项目上海市进一步加快中医药传承创新发展三年行动计划上海儿童医学中心院级科研课题

ZHYY-ZXYJHZX-202027ZY[2021-2023]-0206-08HL-SCMC2018-3

2024

10.3969/j.issn.1674-3865.2024.01.017

中国中西医结合儿科学
中国医师协会，辽宁省基础医学研究所，辽宁中医药大学附属医院

中国中西医结合儿科学

影响因子：1.03
ISSN：1674-3865
年,卷(期)：2024.16(1)
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