关彤从脾肾分期论治系统性硬化症经验

GUAN Tong's Experience in Treating Systemic Sclerosis Based on Stage-Specific Therapy from the Spleen and Kidney

摘要:

介绍关彤教授从脾肾分期论治系统性硬化症的临床经验。关彤教授认为本病病机属本虚标实，其核心在于“阳气失煦，阴凝成积”，并提出“脾-肾-络”动态传变理论，阐释由脾阳不振至肾元衰惫、终致瘀痼损络的病变过程。临证强调分期论治，早期治以温土生金、通阳泄浊，方选补中益气汤合苓桂术甘汤加减；中期治以温补肾阳、化痰祛瘀，方用肾气丸合黄芪桂枝五物汤化裁；晚期则重在温补脾肾、化瘀解毒，于中期方基础上随证加减，以应对多系统纤维化变证。

Abstract:

Abstract：This article introduces Professor GUAN Tong's clinical experience in treating systemic sclerosis based on stage-specific therapy from the spleen and kidney. Professor GUAN believes that the pathogenesis of this disease is characterized by root deficiency and branch excess，with the core lying in "yang qi failing to warm and yin congealing into accumulation. " He proposes a "spleen-kidney-collateral" dynamic transmission theory， elucidating the pathological progression from spleen yang deficiency to kidney original qi depletion，ultimately culminating in stasis and collateral damage. In clinical practice， he emphasizes stage-specific treatment： in the early stage， the treatment focuses on warming the earth （spleen） to generate metal （lung） and unblocking yang to drain turbidity， with modified Buzhong Yiqi Decoction combined with Linggui Zhugan Decoction； in the middle stage， the treatment emphasizes warming and tonifying kidney yang，resolving phlegm and eliminating stasis，using modified Shenqi Pills combined with Huangqi Guizhi Wuwu Decoction； in the advanced stage， the focus is on warming and tonifying the spleen and kidney， resolving stasis and removing toxins， with modifications based on the middle-stage formula according to the syndrome to address multisystem fibrotic complications.