基于"温肾化气,削坚散结"法分期辨治狼疮性肾炎OA

Lupus nephritis(LN)is the most common and serious complication of systemic lupus erythematosus(SLE)and a significant cause of end-stage renal disease.Based on his extensive clinical experience,Professor Wang Yaoguang proposes that the core pathogenesis of LN is characterized by a deficiency-root and excess-manifestation pattern.This manifests as spleen and kidney deficiency with impaired qi transformation as the root deficiency,while the combination of water-dampness,blood stasis,and phlegm-turbidity coalescing constitutes the manifest excess.The disease progression can be divided into three stages:the acute active phase,the protracted transformation phase,and the chronic sclerosing and failure phase.The pathological focus differs at each stage,necessitating stage-differentiated pattern identification and treatment and dynamic therapeutic adjustments.During the acute active phase,the treatment principle focuses primarily on clearing heat and resolving toxicity,and cooling blood to disperse nodules.The protracted transformation phase emphasizes fortifying the spleen and tonifying the kidney,combined with activating blood and draining dampness.In the chronic sclerosing and failure phase,the strategy shifts to warming the kidney,transforming qi and softening hardness,dispersing nodules,and unblocking collaterals;the timely application of insect drugs is also adopted to enhance the effect of unblocking collaterals and transforming stasis.This approach aims to control disease activity,reduce relapse,and delay progression.This approach highlights the advantages of traditional Chinese medicine in managing LN and providing a relatively comprehensive diagnostic and therapeutic framework for clinical practice.