中华肾病研究电子杂志
中華腎病研究電子雜誌
중화신병연구전자잡지
2015年
2期
82-86
,共5页
反流性肾病%中西医结合%诊断%治疗
反流性腎病%中西醫結閤%診斷%治療
반류성신병%중서의결합%진단%치료
Reflux nephropathy%Integrated traditional Chinese and western medicine%Diagnosis%Treatment
反流性肾病(RN)是指由于膀胱输尿管反流(VUR)和肾内反流(IRR)伴反复尿路感染,导致肾脏形成瘢痕、萎缩、肾功能异常的一类临床综合征。RN 是造成 ESRD 的原因之一。RN 最基本的病理特点是肾脏瘢痕形成。常见的临床表现有持续或反复发作的尿路感染、蛋白尿、高血压、夜尿、多尿、腰痛、尿路结石等。治疗上主要包括西医保守治疗、外科治疗及中医治疗。西医保守治疗主要采用抗感染和综合对症治疗措施,以预防和延缓肾实质损害和肾功能减退。外科手术治疗为传统抗反流手术和内镜下注射治疗。RN 中医学属“淋证”、“尿频”、“腰痛”、“遗尿”及“癃闭”等疾病范畴。基本病机为本虚标实,虚实错杂,早期以标实为主,后期以本虚为甚,需辩证施治。
反流性腎病(RN)是指由于膀胱輸尿管反流(VUR)和腎內反流(IRR)伴反複尿路感染,導緻腎髒形成瘢痕、萎縮、腎功能異常的一類臨床綜閤徵。RN 是造成 ESRD 的原因之一。RN 最基本的病理特點是腎髒瘢痕形成。常見的臨床錶現有持續或反複髮作的尿路感染、蛋白尿、高血壓、夜尿、多尿、腰痛、尿路結石等。治療上主要包括西醫保守治療、外科治療及中醫治療。西醫保守治療主要採用抗感染和綜閤對癥治療措施,以預防和延緩腎實質損害和腎功能減退。外科手術治療為傳統抗反流手術和內鏡下註射治療。RN 中醫學屬“淋證”、“尿頻”、“腰痛”、“遺尿”及“癃閉”等疾病範疇。基本病機為本虛標實,虛實錯雜,早期以標實為主,後期以本虛為甚,需辯證施治。
반류성신병(RN)시지유우방광수뇨관반류(VUR)화신내반류(IRR)반반복뇨로감염,도치신장형성반흔、위축、신공능이상적일류림상종합정。RN 시조성 ESRD 적원인지일。RN 최기본적병리특점시신장반흔형성。상견적림상표현유지속혹반복발작적뇨로감염、단백뇨、고혈압、야뇨、다뇨、요통、뇨로결석등。치료상주요포괄서의보수치료、외과치료급중의치료。서의보수치료주요채용항감염화종합대증치료조시,이예방화연완신실질손해화신공능감퇴。외과수술치료위전통항반류수술화내경하주사치료。RN 중의학속“림증”、“뇨빈”、“요통”、“유뇨”급“륭폐”등질병범주。기본병궤위본허표실,허실착잡,조기이표실위주,후기이본허위심,수변증시치。
Reflux nephropathy (RN ) is a kind of clinical syndrome characterized by kidney scarring,atrophy,and renal dysfunction due to vesicoureteral reflux (VUR)and intrarenal reflux (IRR) with recurrent urinary tract infections.RN is one of the important causes of end-stage renal diseases (ESRD),and its basic pathological feature is renal scarring,with common clinical manifestations of continuous or recurrent urinary tract infections,proteinuria,hypertension,nocturia,polyuria,lower back pain,urinary calculi,and so on.The treatment consists of conservative therapy,surgical therapy,and traditional Chinese medicine (TCM) therapy.In western medicine conservative therapy,mainly anti-infection and comprehensive symptomatic treatment are performed in order to prevent or delay renal parenchyma damage and kidney dysfunction,while surgical treatment includes traditional anti-reflux surgery and endoscopic injection therapy.RN in TCM refers to disease categories of “gonorrhea”,“frequent urination”,“osphyalgia”,“nocturnal enuresis”,and “uroschesis”,with a basic pathogenesis comprised of deficiency in origin and excess in superficiality,mixture of deficiency and excess,and early domination of excess in superficiality while later domination of deficiency in origin,which demands treatment with syndrome differentiation.