关键词: 干燥综合征肾损害蛋白尿, 燥湿为纲, 干燥综合征, 新安医学

Abstract:

Renal involvement of Sjögren's syndrome （RISS） clinically manifests primarily as tubulointerstitial nephritis and glomerular disease， often accompanied by symptoms related to proteinuria， hypokalemia， and abnormal calcium-phosphorus metabolism， significantly impacting the quality of life of the patients. Modern medicine cannot cure RISS proteinuria and struggles to address the systemic symptoms of RISS patients comprehensively. This study based on the theory of "dryness and dampness as the guiding principle" proposed by Yu Guopei of the "Xin'an doctors"， combined with our team's clinical experience， analyzes the traditional Chinese medicine （TCM） treatment of RISS proteinuria. It suggests that although the pathological locations involved in RISS are extensive， when proteinuria occurs clinically， the focus is on the spleen and kidney， which are closely related to pathological products such as blood stasis and turbid dampness. The following three major mechanisms and treatments are proposed： ①Dryness disturbing the lungs， causing Qi stagnation and blood stasis. Emphasis should be placed on the causal relationship between dryness， Qi stagnation， and blood stasis. Treatment should focus on nourishing Yin and blood， regulating Qi， and dissolving blood stasis， using modified Jie Zao Decoction； ②Spleen and kidney deficiency， with dryness and dampness intertwined， can lead to the spleen failing to elevate clear Yang and the kidney failing to consolidate essence， resulting in the leakage of fine substances and endogenous damp-turbidity. Treatment should aim at regulating and supplementing the spleen and kidney， restoring Qi movement， using modified Huoxiang Zhengqi Powder； ③Kidney deficiency leading to an imbalance in opening and closing functions exacerbates the degree of fine substance loss. Over-supplementation may result in non-acceptance of tonification. A combination of reinforcement and reduction should be applied， focusing on consolidating the kidney， enriching essence， resolving blood stasis， and expelling turbidity， using modified Jin Suo Gu Jing Wan.

Key words: Sj?gren's syndrome renal involvement proteinuria； , Dryness and dampness as the guiding principle； , Sj?gren's syndrome； , Xin'an Medicine