通讯作者: 王叶, 16589535@qq.com

DOI：10.12201/bmr.202606.00066

Treatment of Renal Proteinuria by Spleen-activating and Essence-regulating Therapy Combined with Qizhu Tiaojing Decoction

• 摘要：蛋白尿是各类慢性肾脏病的核心临床表现，持续蛋白尿会不断损伤肾小球滤过与肾小管重吸收功能，加速肾纤维化进程，现代医学多采用降压、激素、免疫抑制剂等方案干预，存在疗效不稳、不良反应多、病情易反复等问题。王叶主任医师认为本病以脾肾气虚为根本，兼夹湿浊、血瘀为标，尿中蛋白归属于中医“水谷精微”范畴，临证立足脾肾同调，自拟方芪术调精汤疗效显著。本文总结运脾调精理论诊治肾性蛋白尿的病机内涵、组方思路、临证经验，并附典型病案佐证。

  关键词： 运脾调精; 肾性蛋白尿; 脾肾气虚; 湿浊血瘀

   

  Abstract: Objective To explore the pathogenesis theory, formula design, and clinical efficacy of Director Wang Ye’s application of the method of “activating the spleen and regulating essence” in the treatment of renal proteinuria. Methods Based on a review of classical Chinese medicine literature and modern research, the theoretical connotation of “activating the spleen and regulating essence” and the core pathogenesis of spleen-kidney qi deficiency complicated by dampnessturbidity and blood stasis were summarized. The composition, modifications, and modern pharmacological actions of the selfformulated Qizhu Tiaojing Decoction were analyzed, and a typical case was presented to illustrate the diagnostic and therapeutic process. Results Renal proteinuria is characterized by spleenkidney qi deficiency as the root cause, with dampnessturbidity and blood stasis as the superficial manifestations. Qizhu Tiaojing Decoction, based on activating the spleen and supplementing qi, consolidating the kidney and regulating essence, resolving dampness and activating blood, addresses both the root and the superficial aspects. It effectively reduces urinary protein, improves clinical symptoms, and delays disease progression. In the typical case, after treatment with the modified decoction, the 24hour urinary protein significantly decreased, and symptoms such as edema and fatigue disappeared, with stable condition during followup. Conclusion The combination of the method of activating the spleen and regulating essence with Qizhu Tiaojing Decoction has a definite therapeutic effect on renal proteinuria, especially for recurrent and refractory cases, and provides a feasible reference for integrated traditional Chinese and Western medicine in the diagnosis and treatment of renal proteinuria.

  Key words: Activating the spleen and regulating essence; Renal proteinuria; Spleenkidney qi deficiency; Dampnessturbidity and blood stasis

  提交时间：2026-06-22

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• 序号	提交日期	编号	操作
  1	2026-06-10	10.12201/bmr.202606.00066V1	下载

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