郑健教授基于“分期协同、序贯增效”原则辨治儿童难治性肾病综合征的经验撷要

doi:10.20274/j.cnki.issn.1674-3865.2026.02.010

Abstract

Abstract:

This paper summarizes Professor Zheng Jian's academic thought and clinical experience in treating refractory nephrotic syndrome (RNS), focusing on his integrated traditional Chinese and western medicine scheme of treating RNS with traditional Chinese medicine and rituximab (RTX). Based on the combination of disease and syndrome and clarification of pathogenesis, a strategy of treatment by stages is established in the scheme, which consolidates the foundation by strengthening the spleen and tonifying the kidney and deals with its symptoms by promoting blood circulation and eliminating dampness, and dynamically adjusts the traditional Chinese medicine prescriptions according to the different stages of the disease and the characteristics of RTX, so as to leverage the synergistic effects of integrated traditional Chinese and western medicine to reduce toxicity and enhance efficacy. Clinical practice has proved that this scheme can significantly enhance the efficacy of RTX, reduce adverse reactions and recurrence rate of RNS, and provide an effective reference for the treatment of RNS with integrated traditional Chinese and western medicine.

Key words: Refractory nephrotic syndrome, Rituximab, Integrated traditional Chinese and western medicine, Famous doctor experience, Child

CLC Number:

R692

Meifang CHEN, Jian ZHENG. Professor Zheng Jian's experience in treating refractory nephrotic syndrome in children based on the principle of "phased collaboration and sequential synergy"[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2026, 18(2): 141-146.

Figures/Tables 2

Table 1

Table 2

References 30

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证型	治法	核心方药	临证加减
肺脾气虚	益气健脾宣肺利水	防己黄芪汤合五苓散加减	水肿甚加五皮饮
脾肾阳虚	温肾健脾化气行水	偏肾阳虚：黄芪桂枝五物汤偏脾阳虚：实脾饮	水湿重者加五苓散
肝肾阴虚	滋阴补肾平肝潜阳	知柏地黄丸加减	肝阴虚甚者加沙参、菊花、夏枯草等
气阴两虚	益气养阴	自拟肾康灵加减	气虚甚者重用黄芪、党参、白术
外感	外感风寒者：辛温宣肺祛风外感风热者：辛凉宣肺祛风	外感风寒者：麻黄汤加减外感风热者：银翘散加减	伴有水肿者可加五苓散
水湿	补气健脾，逐水消肿	防己黄芪汤合己椒苈黄丸加减	脘腹胀满者加大腹皮、厚朴、莱菔子
湿热	清热利湿	上焦湿热：五味消毒饮加减中焦湿热：甘露消毒饮加减下焦湿热：八正散加减	上焦湿热用金银花、蒲公英、菊花等中焦湿热用藿香、黄芩、连翘等下焦湿热用车前草、栀子、滑石等
血瘀	活血化瘀	桃红四物汤加减	尿血者加仙鹤草、蒲黄炭、茜草、三七
湿浊	利湿降浊	温胆汤加减	湿邪偏重者，加苍术、厚朴、薏苡仁

观察指标	治疗前	治疗3周	治疗11周	治疗24周
24 h尿蛋白定量(g)	6.903	未测	未测	未测
尿蛋白	+++	阴性	阴性	阴性
血清白蛋白(g/L)	29.2	30.8	44.9	46.6
血清总胆固醇(mmol/L)	8.74	未测	5.56	5.37
血肌酐(μmol/L)	43.8	43.0	44.4	47.5
水肿程度	重度	无	无	无

Professor Zheng Jian's experience in treating refractory nephrotic syndrome in children based on the principle of "phased collaboration and sequential synergy"

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