Discussion on the pathogenesis and treatment of Henoch-Schönlein purpura nephritis in children based on the theory of "xuanfu opening and closing, collaterals dredging and blocking"

XING Yaping; HAN Shanshan; DING Ying; LIU Jiajia; He Zhuozhuo; DING Lele

doi:10.3969/j.issn.1006-2157.2023.06.015

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Discussion on the pathogenesis and treatment of Henoch-Schönlein purpura nephritis in children based on the theory of "xuanfu opening and closing, collaterals dredging and blocking"

Clinical Studies | 更新时间：2023-07-05

- Discussion on the pathogenesis and treatment of Henoch-Schönlein purpura nephritis in children based on the theory of "xuanfu opening and closing, collaterals dredging and blocking"
- Journal of Beijing University of Traditional Chinese Medicine Vol. 46, Issue 6, Pages: 842-847(2023)
- 作者机构：
  
  1.河南中医药大学儿科医学院　郑州　450046
  2.河南中医药大学第一附属医院儿科
- 作者简介：
  
  Prof. DING Ying, Master of Chinese Medicine, Chief Physician, Doctoral Supervisor. The First Affiliated Hospital of Henan University of Chinese Medicine, No.19, Renmin Road, Jinshui District, Zhengzhou 450003.E-mail: dingying3236@sina.com
- 基金信息：
  
  National Natural Science Foundation of China(81873343);Special Project of Scientific Research on Traditional Chinese Medicine in Henan Province(20-21ZY2031);Scientific Research Project of China Medical Association of Minorities(2020ZY265-400603)
- DOI：10.3969/j.issn.1006-2157.2023.06.015
  CLC： R272.59
- Received：07 November 2022，
  
  Online First：12 April 2023，
  
  Published：30 June 2023
- 稿件说明：
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XING Yaping, HAN Shanshan, DING Ying, et al. Discussion on the pathogenesis and treatment of Henoch-Schönlein purpura nephritis in children based on the theory of "xuanfu opening and closing, collaterals dredging and blocking"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(6): 842-847.
DOI：

XING Yaping, HAN Shanshan, DING Ying, et al. Discussion on the pathogenesis and treatment of Henoch-Schönlein purpura nephritis in children based on the theory of "xuanfu opening and closing, collaterals dredging and blocking"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(6): 842-847. DOI： 10.3969/j.issn.1006-2157.2023.06.015.

摘要

儿童过敏性紫癜性肾炎是以皮肤紫癜伴见血尿和(或)蛋白尿为主要表现的免疫紊乱性疾病，随着该病的发病率增高，其治疗和预防逐渐受到重视。根据其临床症状将此病归属于中医学“紫癜风”“水肿”“尿浊”等范畴，并认为络脉亦参与疾病的发生。而肾玄府作为与络脉共同执行肾脏渗灌、运行气血津液功能的微观结构，亦在过敏性紫癜性肾炎的病变过程中发挥重要作用。肾玄府开阖有节，络脉疏塞通利，则肾脏功能正常，肾络不受邪扰，仅表现为皮肤紫癜；肾玄府开阖失司，络脉疏塞不利，则肾络受损，导致过敏性紫癜性肾炎的发生。基于此，提出过敏性紫癜性肾炎的发生发展可分为络脉受邪，肾玄府开放；络脉空虚，肾玄府失控；玄闭络瘀，火生痰阻3个阶段。因此，从“肾玄府开阖、络脉疏塞”角度出发，初步探讨过敏性紫癜性肾炎“宁络清玄”“荣络调玄”“开玄通络”阶段化的治则治法，以期为临床治疗该疾病提供治疗新思路。

Abstract

Henoch-Schönlein purpura nephritis (HSPN) in children is an immune disorder disease characterized by skin purpura accompanied by hematuria with or without proteinuria. Because of an increasing incidence rate

its treatment and prevention are gradually attracting greater attention. According to its clinical symptoms

the disease is classified as "purpura wind" "edema" and "cloudy urine"

and it is believed that collaterals are involved in the occurrence of the disease. As a microstructure that cooperates with the collaterals to perform the functions of kidney filtration and circulation of qi

blood

and body fluids

the kidney xuanfu also plays an important role in the pathological process of HSPN. If the opening and closing of the kidney xuanfu are orderly

and the collaterals are circulating smoothly

the kidney function is normal

the renal collaterals are not disturbed by evil factors

and the disease only manifests as skin purpura. If the opening and closing of the kidney xuanfu are not controlled properly

and the collaterals are blocked

the renal collaterals will be damaged

which will lead to the occurrence of HSPN. In view of this

this article proposes that the occurrence and development of HSPN can be divided into three stages: (ⅰ) the collaterals are disturbed by pathogenic factors

and the kidney xuanfu is open; (ⅱ) the collaterals are empty

and the kidney xuanfu is not controlled; and (ⅲ) the xuanfu is closed

the collaterals and blood exhibit stasis

and fire generates and phlegm retention appears. In addition

our team initially explored the treatment principles and method of HSPN based on the principle of "calming the collaterals and clearing the xuanfu"

"nourishing the collaterals and regulating the xuanfu"

and "opening the xuanfu and dredging the collaterals" from the perspective of "the opening and closing of the kidney xuanfu

and the dredging and blocking of collaterals"

with a view to providing new ideas for clinical treatment.

关键词

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