CAJ | 학술논문

糖皮质激素（激素）抵抗型肾病综合征（SRNS）是肾脏病临床常见的疑难病症之一，属难治性肾病综合征。已有越来越多的学者探索中西医结合治疗方法，以提高临床疗效及缓解长期大剂量免疫抑制剂所带来的副反应。笔者在本文中系统阐述了产生激素抵抗的机制和影响激素疗效的因素，提出应注重规范化治疗，将中医辨“病”治疗的雷公藤制剂联合个体化的辨“证”治疗、传统辨证与微观辨证相结合，组方选药结合中药现代研究结果，是中西医结合治疗 SRNS 可借鉴的方法。
당피질격소（격소）저항형신병종합정（SRNS）시신장병림상상견적의난병증지일，속난치성신병종합정。이유월래월다적학자탐색중서의결합치료방법，이제고림상료효급완해장기대제량면역억제제소대래적부반응。필자재본문중계통천술료산생격소저항적궤제화영향격소료효적인소，제출응주중규범화치료，장중의변“병”치료적뢰공등제제연합개체화적변“증”치료、전통변증여미관변증상결합，조방선약결합중약현대연구결과，시중서의결합치료 SRNS 가차감적방법。
Steroid-resistant nephrotic syndrome (SRNS)is one of the common difficult kidney diseases in clinical practice,and belongs to intractable nephrotic syndrome.A growing number of scholars have been exploring treatment with integrative traditional Chinese and western medicine so as to improve clinical efficacy and ease the side effects from long-term use of high-dose immunosuppressants.In this article,the author systematically described steroid-resistance mechanism and factors affecting the effect of the steroid,and proposed to pay attention to standardized treatment.The following methods are worth using for reference in treatment of SRNS,including combination of tripterygium wilfordii preparation as “disease”differentiation treatment of traditional Chinese medicine with individualized dialectical treatment,combination of traditional syndrome differentiation and microcosmic syndrome differentiation, and combination of prescription selection with modern research results of traditional Chinese medicine.