阮诗玮横纵辨证视域下从湿论治肾性血尿OA

This article summarizes Professor Ruan Shiwei's clinical experience in treating Renal Hematuria(renal he-maturia,RH)based on the theory of Horizontal and Vertical Syndrome Differentiation,with dampness as the central patho-genic focus.Professor Ruan considers dampness as the key pathological factor in the onset and progression of RH.Damp-ness tends to obstruct the Ying(Nutrient)and Wei(Defense)systems,transforming into heat;impairs the qi transforma-tion of the Sanjiao,giving rise to turbidity;and induces stagnation in the renal collaterals,leading to blood stasis,thereby precipitating the disease.Consequently,RH typically follows the pathological progression from dampness-heat to damp-ness-turbidity and ultimately to dampness-stasis.Based on this,the core pathogenesis of RH is proposed as disharmony between the Horizontal and Vertical dimensions,transformation of dampness-heat into turbidity,collateral damage,and blood stasis.Specifically:From the Horizontal perspective(Wei-Qi-Ying-Xue Syndrome Differentiation),the initial stage of RH involves obstruction of the Ying and Wei systems,leading to endogenous dampness-heat.From the Vertical perspec-tive(Sanjiao Syndrome Differentiation),impaired qi transformation of the Sanjiao,producing endogenous dampness-turbid-ity,is a key factor in the progression of RH.The final outcome results from the interwoven disharmony of both Horizontal and Vertical dimensions,forming intractable endogenous dampness-stasis.Accordingly,from the"Horizontal and Vertical Syndrome Differentiation"perspective,Professor Ruan's specific treatment strategies for RH are as follows:For RH charac-terized by Ying-Wei stagnation and dampness-heat contention:Modified Qiaohe Tang combined with Shangjiao Xuanbi Tang are used to diffuse Ying-Wei,disperse dampness,and clear heat.For RH characterized by qi transformation failure and downward flow of dampness-turbidity:Shengyang Yiwei Tang is employed to uplift clear Yang,transform qi,drain dampness,and eliminate turbidity.For RH characterized by dampness-turbidity persisting for a long time,lingering in the kidney collaterals and eventually leading to stasis,with dampness and stasis intermingling in an intractable entanglement:Zi Qian Ningxue Tang combined with Mahuang Lianqiao Chixiaodou Tang are applied to eliminate dampness,dispel sta-sis,cool the blood,and dispel pathogens.This approach aims to provide new insights for the syndrome differentiation and treatment of RH.