慢性腎炎併發慢性肝炎治療經驗

Clinical Experience of Treating Chronic Nephritis with Complication of Chronic Hepatitis

鐘文冠(Wen-Kuan Chung)

《北台灣中醫醫學雜誌》 4卷1期 (2012/06) Pp. 27-42

https://doi.org/10.30127/BTWZYYXZZ.201206.0003

摘要

依據醫學報導台灣慢性腎炎（CKD，Chronic Kidney Dis.）的盛行率為20％，CKD診斷是GFR（腎小球過濾率）＜95 ml／min，即是第一期（stage I）。未來在臨床上併發慢性肝炎的病例必將增加，而提出慢性腎炎合併慢性肝炎病案驗案報告，並就教方家。慢性腎炎的病機和慢性肝炎（Chronic Hepatitis）相同，皆與濕、熱、痰、瘀、虛有關。慢性腎炎，腎陽虛致濕，腎陰虛致熱。由於腎虛使病毒（Virus）易於侵入。由於慢腎和慢肝引致濕熱蘊結，疏泄失常，痰瘀交阻，虛實夾雜，甚而引致肝侵脾，由二臟至三臟更增治療困難。GOT和GPT上升表示肝細胞壞死，將使肌酸酐（Creatinine）的製造降低。中醫理論肝腎同源，但因肝可以再生，故慢腎併慢肝治療中，先見GOT和GPT降至正常，但會見肌酸酐上升，需在治療前說明，才不會引起誤會。

並列摘要

The prevalence of chronic kidney disease (CKD) is around 20%. The criteria of stage I of CKD is GFR(Glomerular Filtration Rate) ＜ 95 ml/min. In the future, there would be more and more cases of chronic kidney disease with complication of chronic hepatitis. Therefore I present my case report about treating chronic kidney disease with complication of chronic hepatitis by Chinese medicine for consultation with colleagues.The mechanism of chronic nephritis and chronic hepatitis are similar, they are common in the pathogenesis of dampness, heat, phlegm, blood stagnation and qi vacuity. Renal Yang Vacuity cause the dampness of patient, and Renal Ying Vacuity cause the heat within. Due to renal vacuity, patients are easily infected by the virus. Chronic nephritis and chronic hepatitis would cause accumulation of dampness and heat, malfunction of urination and stagnation of phlegm and blood stasis, mingling of deficiency and excess of vitality within body, even cause the infection of spleen from liver, with would let the therapy become more complicated from the bi-visceral treatment to tri-visceral treatment.

並列關鍵字

Chronic Kidney Disease (CKD) ； Chronic Hepatitis ； GFR (Glomerular Filtration Rate)