王小菊 胡国恒 刘柏炎 王行宽

〔摘要〕 首届全国名中医王行宽认为风热毒邪为过敏性紫癜性肾炎（Henoch-Schonlein purpura nephritis， HSPN）致病之因，早期主因风热夹毒，潜伏于营血，湿热蕴结致瘀，久之脏真虚衰，内犯肾脏，肾失封藏，营精暗泄，发为“溺毒”，其病机与“风、热、湿、毒、瘀、虚”密切相关。治疗上早期以疏风清热，凉血泄毒为主，方用清瘟败毒饮或银翘散加减;久之应加补肾益精填髓之品，方用六味地黄丸或五子衍宗丸加减，并时时不忘“治肝”之法。王老师治疗HSPN强调“微观辨证”的学术理念，善将现代医学检测方法融为我用。他认为运用古代知识治疗疾病，也应适时结合现代新技术、新方法，融古于今、今为我用，不断开拓创新，以提高疾病治疗效果。

〔关键词〕 过敏性紫癜性肾炎;微观辨证;王行宽

〔中图分类号〕R259;R692.3+4       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.04.017

〔Abstract〕 National famous Chinese medicine Wang Xingkuan believes that wind and heat are the cause of Henoch-schonlein purpura nephritis， the main disease in the early stage is wind-heat and toxin， pathogenic factors lurking in the nutrient-blood， damp and heat accumulation， causing blood stasis， and after a long time， the organs are empty and weak， committing internal kidneys， the kidneys are not sealed， and the essence is leaked， and finally develops into "drowning poison". Its pathogenesis is closely related to “wind， heat， dampness， poison， blood stasis and deficiency”. So the treatment is to relieve wind， clear heat， cool blood and relieve toxin in the early stage， modified Qingwen Baidu Decoction or Yinqiao Powder are used as the prescription; for a long time， it is necessary to supplement the products of kidney， essence and marrow， modified Liuwei Dihuang Pill or Wuzi Yanzong Pill are used as the prescription， and not forget the method of "treating liver". At the same time， professor Wang emphasizes the academic concept of "micro dialectics" in the treatment of Henoch-schonlein purpura nephritis. He is good at integrating modern medical testing methods for our use. He believes that the use of ancient knowledge in the treatment of diseases should also be timely combined with modern new technology and new methods， we should integrate the past with the present and applies it to us and make continuous innovation to improve the treatment effect of diseases.

〔Keywords〕 Henoch-schonlein purpura nephritis; micro dialectics; Wang Xingkuan

王行寬教授，系首届全国名中医，从事临床、科研及教学工作50余年，精通中医学，旁谙现代医学，师古不泥古，刻意创新。通过数十年的临床实践及科研教学，形成了“杂病治肝，多脏调燮，微观辨证，疏通督脉”学术思想。擅长肾系疾病、心脑血管疾病、脾胃疾病、急危重症及疑难杂症的治疗，其立论多具创见，治法颇具特色，根据脏腑生化制约的相关性，对于慢性疾病及疑难杂症擅长综合分析，多脏调燮，尤倡“杂病治肝”，对运用“微观辨证”思想指导中医药治疗过敏性紫癜性肾炎（henoch-schonlein purpura nephritis， HSPN）有独到见解，疗效颇佳。

HSPN，又称免疫球蛋白A血管炎，属于系统性小血管炎，主要根据临床情况作出诊断，95%的患者初期有皮疹以及胃肠道、骨骼肌和肾脏系统四联征，但临床上并非均有四联症。……