王永钧国医大师治疗膜性肾病Ⅱ期伴IgA肾病验案一则
Master of National Physician Wang Yongjun's Experience in Treating Membranous Nephropathy II with IgA Nephropathy: A Case Report
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1.杭州市中医院肾内科,杭州,310007
2.主诊人:王永钧,中西医结合防治肾脏病, :王永钧
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王永钧, 杨亚珍, 金德. 王永钧国医大师治疗膜性肾病Ⅱ期伴IgA肾病验案一则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32138274&Fpath=home&index=0
WANG yongjun, Yang yazhen, Jin de. Master of National Physician Wang Yongjun's Experience in Treating Membranous Nephropathy II with IgA Nephropathy: A Case Report[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32138274&Fpath=home&index=0
王永钧, 杨亚珍, 金德. 王永钧国医大师治疗膜性肾病Ⅱ期伴IgA肾病验案一则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32138274&Fpath=home&index=0 DOI:
WANG yongjun, Yang yazhen, Jin de. Master of National Physician Wang Yongjun's Experience in Treating Membranous Nephropathy II with IgA Nephropathy: A Case Report[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32138274&Fpath=home&index=0 DOI:
病史摘要,2,患者主因“下肢水肿伴尿泡沫增多”于我院就诊。患者于2010年4月底,出现下肢凹陷性水肿,尿中泡沫增多,后就诊于当地医院,诊断为膜性肾病Ⅰ-Ⅱ期,给予糖皮质激素(泼尼松)及环磷酰胺治疗,患者因治疗效果不明显,于2010年10月13日求诊于王永钧教授。刻下见疲惫及焦虑状,满月脸,伴痤疮,眼睑轻度浮肿,下肢凹陷性水肿,脉弦滑,舌苔薄腻。,中医诊断 ,肾风水疾,风湿、肾虚二联证。,西医诊断, 肾病综合征(膜性肾病Ⅱ期伴IgA肾病),药物性肝病。,干预措施 ,中西医结合治疗。,疗效转归 ,患者坚持服药治疗,2012年3月复查尿常规及24小时尿蛋白定量转阴,以后只在过劳、感冒发热,饮食过多的油腻厚味等特殊状况,出现一过性的蛋白尿,待诱发因素消除,尿检即能阴转,已使临床基本缓解。
of case historyThe patient came to our hospital mainly complained of "lower extremity edema with increased urine foam". At the end of April 2010, the patient developed pitted edema of the lower extremities and increased foam in urine. Later, he was diagnosed as membranous nephropathy stage I-II in a local hospital and was treated with glucocorticoids (prednisolone) and cyclophosphamide. Because the treatment effect was not obvious, the patient sought help from Professor Yongjun Wang on October 13, 2010. At that time,the patient has symptoms such as fatigue and anxiety, full moon face, acne, mild eyelid swelling, lower limb depression edema, string and slippery pulse, and thin glossy coating of the tongue.,TCM diagnoses, Kidney feng shui disease, diplexia of wind-damp and deficiency of the kidney,Western medicine diagnosis ,1. Nephrotic syndrome (membranous nephropathy II with IgA nephropathy) 2. Drug-induced liver disease.,Therapeutic methods ,Integrated traditional Chinese and Western medicine treatment.,Clinical outcomes ,The patient persisted in taking medication. In March 2012, the patient's routine urine examination and 24-hour urine protein quantification turned negative. After that, transient proteinuria occurred only in special conditions such as overwork, cold and fever, and excessive diet with fat and thick taste. When the inducing factors are eliminated, the urine test can be negative. Overall,the patient has reached clinical remission.
膜性肾病Ⅱ期伴IgA肾病肾风水疾风湿、肾虚二联证病例报告【适合阅读专业】
Membranous Nephropathy II with IgA NephropathyKidney feng shui diseasediplexia of wind-damp and deficiency of the kidneycase report【Suitable majors】
Jeon SJ, Kim JH, Noh HW, et. Treatment of rituximab in patients with idiopathic membranous nephropathy: a case series and literature review. Korean J Intern Med. 2022 Jul;37(4):830-840. doi: 10.3904/kjim.2021.155. Epub 2022 Apr 15. PMID: 35421909; PMCID:http://dx.doi.org/10.3904/kjim.2021.155.Epub2022Apr15.PMID:35421909;PMCID:PMC9271724.
Xia J, Wang M, Jiang W. New insights into pathogenesis of IgA nephropathy. Int Urol Nephrol. 2022 Aug;54(8):1873-1880. doi: 10.1007/s11255-021-03094-0http://dx.doi.org/10.1007/s11255-021-03094-0. Epub 2022 Jan 20. PMID: 35048307.
卞淑芬,刘声茂,林萍.膜性肾病合并IgA肾病1例报告[J].中国实验诊断学,2020,24(12):2046-2047.
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