切换至 "中华医学电子期刊资源库"

中华肾病研究电子杂志 ›› 2015, Vol. 04 ›› Issue (02) : 82 -86. doi: 10.3877/cma.j.issn.2095-3216.2015.02.006

所属专题: 文献

专家论坛

反流性肾病的中西医诊治现状
刘华锋1,(), 安宁1, 刘伟敬1   
  1. 1. 524001 广东省湛江市,广东医学院附属医院肾病研究所
  • 出版日期:2015-04-28
  • 通信作者: 刘华锋

Current diagnosis and treatment of reflux nephropathy with integrated traditional Chinese and western medicine

Huafeng Liu1,(), Ning An1, Weijing Liu1   

  1. 1. Institute of Nephrology, Guangdong Medical College Affiliated Hospital, Zhanjiang 524001, Guangdong Province, China
  • Published:2015-04-28
  • Corresponding author: Huafeng Liu
  • About author:
    Corresponding author: Liu Huafeng, Email:
引用本文:

刘华锋, 安宁, 刘伟敬. 反流性肾病的中西医诊治现状[J/OL]. 中华肾病研究电子杂志, 2015, 04(02): 82-86.

Huafeng Liu, Ning An, Weijing Liu. Current diagnosis and treatment of reflux nephropathy with integrated traditional Chinese and western medicine[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2015, 04(02): 82-86.

反流性肾病(RN)是指由于膀胱输尿管反流(VUR)和肾内反流(IRR)伴反复尿路感染,导致肾脏形成瘢痕、萎缩、肾功能异常的一类临床综合征。RN是造成ESRD的原因之一。RN最基本的病理特点是肾脏瘢痕形成。常见的临床表现有持续或反复发作的尿路感染、蛋白尿、高血压、夜尿、多尿、腰痛、尿路结石等。治疗上主要包括西医保守治疗、外科治疗及中医治疗。西医保守治疗主要采用抗感染和综合对症治疗措施,以预防和延缓肾实质损害和肾功能减退。外科手术治疗为传统抗反流手术和内镜下注射治疗。RN中医学属"淋证"、"尿频"、"腰痛"、"遗尿"及"癃闭"等疾病范畴。基本病机为本虚标实,虚实错杂,早期以标实为主,后期以本虚为甚,需辩证施治。

Reflux nephropathy (RN) is a kind of clinical syndrome characterized by kidney scarring, atrophy, and renal dysfunction due to vesicoureteral reflux (VUR) and intrarenal reflux (IRR) with recurrent urinary tract infections. RN is one of the important causes of end-stage renal diseases (ESRD), and its basic pathological feature is renal scarring, with common clinical manifestations of continuous or recurrent urinary tract infections, proteinuria, hypertension, nocturia, polyuria, lower back pain, urinary calculi, and so on. The treatment consists of conservative therapy, surgical therapy, and traditional Chinese medicine (TCM) therapy. In western medicine conservative therapy, mainly anti-infection and comprehensive symptomatic treatment are performed in order to prevent or delay renal parenchyma damage and kidney dysfunction, while surgical treatment includes traditional anti-reflux surgery and endoscopic injection therapy. RN in TCM refers to disease categories of "gonorrhea" , "frequent urination" , "osphyalgia" , "nocturnal enuresis" , and "uroschesis" , with a basic pathogenesis comprised of deficiency in origin and excess in superficiality, mixture of deficiency and excess, and early domination of excess in superficiality while later domination of deficiency in origin, which demands treatment with syndrome differentiation.

[1]
Bailey RR. The relationship of vesico-ureteric reflux to urinary tract infection and chronic pyelonephritis-reflux nephropathy [J]. Clin Nephrol, 1973, 1(3): 132-141.
[2]
Fillion ML, Watt CL, Gupta IR. Vesicoureteric reflux and reflux nephropathy: from mouse models to childhood disease [J]. Pediatr Nephrol, 2014, 29(4): 757-766.
[3]
Canadian Institute for Health Information. Canadian Organ Replacement Register Annual Report: Treatment of End-Stage Organ Failure in Canada, 2000 to 2009 [M]. Ottawa: Canadian Institute for Health Information, 2011: 47.
[4]
North American Pediatric Renal Trials and Collaborative Studies: NAPRTS annual report [EB/OL] 2011.

URL    
[5]
Edwards D, Normand IC, Prescod N, et al. Disappearance of vesicoureteric reflux during long-term prophylaxis of urinary tract infection in children [J]. Br Med J, 1977, 2(6082): 285-288.
[6]
Roberts JA. Vesicoureteral reflux and pyelonephritis in the monkey: a review [J]. J Urol, 1992, 148(5 Pt 2): 1721-1725.
[7]
Ransley PG, Risdon RA. Renal papillary morphology and intrarenal reflux in the young pig [J]. Urol Res, 1975, 3(3): 105-109.
[8]
Hodson CJ. Reflux nephropathy: A personal historical review [J]. Am J Roentgenol, 1981, 137(3): 451-462.
[9]
Johnston JH. The significance of intrarenal reflux[M]// Johnston JH. Management of vesieoureteric reflux. Baltirnore: Wiliams and Wilkins, 1984: 36-39.
[10]
Ragnarsdóttir B, Lutay N, Grönberg-Hernandez J, et al. Genetics of innate immunity and UTI susceptibility [J]. Nat Rev Urol, 2011, 8(8): 449-468.
[11]
Androulakakis PA, Ransly PG, Risdon PA, et al. Microvaseular changes in the early stage of reflux pyelonephritis [J]. Eur Urol, 1987, 13(4): 219-223.
[12]
Cendron M. Reflux nephropathy [J]. J Pediatr Urol, 2008, 4(6): 414-421.
[13]
王海燕. 肾脏病学[M]. 第3版. 北京:人民卫生出版社,2008: 1286-1291.
[14]
RIVUR Trial Investigators, Hoberman A, Greenfield SP, et al. Antimicrobial prophylaxis for children with vesicoureteral reflux [J]. N Engl J Med, 2014, 370(25): 2367-2376.
[15]
Yavuz S, Anarat A, Bayazt AK. Interleukin-18, CRP and procalcitonin levels in vesicoureteral reflux and reflux nephropathy [J]. Ren Fail, 2013, 35(10): 1319-1322.
[16]
Dillon MJ, Goonasekera CD. Reflux nephropathy [J]. J Am Soc Nephrol, 1998, 9(12): 2377-2383.
[17]
Jungers P, Houillier P, Chauveau D, et al. Pregnancy in women with reflux nephropathy [J]. Kidney Int, 1996, 50(2): 593-599.
[18]
李幼姬,黄锋先. 成人膀胱输尿管反流及反流性肾病的临床研究 [J]. 中华肾脏病杂志,1991, 7(6): 341-344.
[19]
Slabbaert K, Bogaert G. Vesicoureteric reflux (VUR) in children: where are we now [J]. Arch Esp Urol, 2012, 65(4): 450-458.
[20]
Tse KS, Wong LS, Lau HY, et al. Paediatric vesicoureteric reflux imaging: where are we? Novel ultrasound-based voiding urosonography [J]. Hong Kong Med J, 2014, 20(5): 437-443.
[21]
Westwood ME, Whiting PF, Cooper J, et al. Further investigation of confirmed urinary tract infection (UTI) in children under five years: a systematic review [J]. BMC Pediatr, 2005, 5(1): 2.
[22]
El-Khatib MT, Becker GJ, Kincaid-Smith PS. Morphometric aspects of reflux nephropathy [J]. Kidney Int, 1987, 32(2): 261-266.
[23]
Wong IY, Copp HL, Clark CJ, et al. Quantitative ultrasound renal parenchymal area correlates with renal volume and identifies reflux nephropathy [J]. J Urol, 2009, 182(4 Suppl): 1683-1687.
[24]
Kincaid-Smith PS. Diffuse parenchymal lesions in reflux nephropathy and the possibility of making a renal biopsy diagnosis in reflux nephropathy [J]. Contrib Nephrol, 1984, 39: 111-115.
[25]
Lavocat MP, Granjon D, Allard D, et al. Imaging of pyelonephritis [J]. Pediatr Radiol, 1997, 27(2): 159-165.
[26]
Brakeman P. Vesicoureteral reflux, reflux nephropathy, and end-stage renal disease [J]. Adv Urol, 2008, 2008: 508949.
[27]
Tekgül S1, Riedmiller H, Hoebeke P, et al. EAU guidelines on vesicoureteral reflux in children [J]. Eur Urol, 2012, 62(3): 534-542.
[28]
Leclair MD, Héloury Y. Non-neurogenic elimination disorders in children [J]. J Pediatr Urol, 2010, 6(4): 338-345.
[29]
Peters CA, Skoog SJ, Arant BS Jr, et al. Summary of the AUA Guideline on Management of Primary Vesicoureteral Reflux in Children [J]. J Urol, 2010, 184(3): 1134-1144.
[30]
Sung J, Skoog S. Surgical management of vesicoureteral reflux in children [J]. Pediatr Nephrol, 2012, 27(4): 551-561.
[31]
王钢,陈以平,邹燕勤. 现代中医肾脏病学[M]. 北京:人民卫生出版社,2003:799-809.
[32]
范萍,吕宏生. 吕承全治疗返流性肾病经验 [J]. 河南中医药学刊,2000, 15(5): 6-7.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 778-784.
[3] 易柏成, 李旭光, 王容容, 王新璇. 数字化3D打印导板应用于上前牙钙化根管治疗2例[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 385-390.
[4] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[5] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[6] 刘柏隆, 周祥福. 压力性尿失禁阶梯治疗的项目介绍[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 125-125.
[7] 刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[8] 王秋生. 胆道良性疾病诊疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 779-782.
[9] 陈杰, 武明胜, 李一金, 李虎, 向源楚, 荣新奇, 彭健. 低位直肠癌冷冻治疗临床初步分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 494-498.
[10] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[11] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[12] 王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
[13] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[14] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[15] 崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?