基于“阴阳水火气血论”和“皮部络脉理论”论治免疫球蛋白A型血管炎肾炎

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[关键词］免疫球蛋白A型血管炎肾炎；阴阳水火气血论；皮部；络病；分期论治[中图分类号]R256.59； ［文献标志码］A [文章编号]0256-7415（2026）04-0123-05DOl：10.13457/j.cnki.jncm.2026.04.020

Treatment of Immunoglobulin A Vasculitis with Nephritis Based on the Theory of "Yin-Yang，Water-Fire，and Qi-Blood" and the Theory of "Cutaneous Region and Collaterals"

CHEN Enhui，SHI Wen，XU Jingying，HE Wenhui，YU Dongrong

Hangzhou TCM Hospital of Zhejiang Chinese Medical University，Hangzhou Zhejiang 31OoO7，Chin：

Abstract：ImmunoglobulinAvasculitis with nephritis（IgAVN） isacommon secondary glomerulonephritis with an unclear pathogenesis，and there isno unified standardforitssyndrome diferentiationand treatment in traditional Chinesemedicine（TCM）.The theoryof "yin-yang，water-fire，andqi-blood"isasyndrome differentiation theory proposed by TANG Zonghai，a physician in the late Qing Dynasty，which posits the interdependence of qi，blood， water，and fireasmanifestationsof yinand yang.The theoryof"cutaneous regionandcollaterals"isa TCMtheory centered on the "cutaneous regions"and "collterals." Basedon these two theories，thecourse of IgAVNcan be divided intothree stages：In the initial stage，the pathogenesis involves insufficiency of qi and water，pathogenic factors invading theyang collaterals，andfire-induced disordersinvolves theblood.The treatment principleis treating incidental aspect in thecaseof emergency，with therapies such as dispeling wind，releasing theexterior，nourishing yin，andcooling the blood.In the middle stage，pathogenic factorsenter theyincolaterals，causing blood stasis obstructing the kidneycollaterals.Treatmentat this stage should target both theroot causeand symptoms，by eliminating pathogens，unblocking colaterals，activating blood circulation，andresolving stasis.In the late stage， healthyqiis deficient while pathogenic factors linger，internal retentionof tubidityand toxin，with greatdamage to kidney.The treatment principle is simultaneous application of purging and nourishing therapeutics，using therapies such as tonifying the kidney，activating blood circulation，unblocking bowel movement，and lowering turbid.At this stage，dialysis may be necessary to preserve life.

Keywords：Immunoglobulin A vasculitiswith nephritis；Theory of yin-yang，water-fire，and qi-blood; Cutaneous region；Collateral disease；Stage-specific treatment

免疫球蛋白A型血管炎（IgAV）是一种主要累及皮肤、胃肠道、关节及肾脏的系统性小血管炎。（剩余7004字）