基于“肾虚邪瘀”理论探讨IgG4相关性疾病的中医治疗

Exploration of Traditional Chinese Medicine Treatment for IgG4 Related Diseases Based on the Theory of “Kidney Deficiency with Pathogenic Stasis”

摘要: IgG4相关性疾病(immunogolobulin-G4 related disease, IgG4-RD)是一种基于免疫炎症反应，以组织纤维化和浆细胞浸润为主要特征的免疫性疾病。其发病机制尚不明确，现代医学以激素类药物为主要治疗方法，但具有一定的局限性及潜在副作用。中医认为本病为本虚标实之证，“肾虚邪瘀”为核心病机，肾虚为发病根本，外感邪气趁虚而入，内生邪气稽留难去，逐渐蓄积形成有形实邪而发病，中医治疗本病时重视培固肾气以扶正，兼化痰通瘀以祛邪，标本兼治，帮助更稳定地控制病情并预防复发。文章论述对IgG4-RD的中医认识及疾病治疗思路，并附医案一则，为中医药治疗本病提供一定的参考。

Abstract: IgG4 related disease (IgG4-RD) is an immune related disease characterized by tissue fibrosis and plasma cell infiltration based on immune inflammatory response. The pathogenesis is not yet clear, and modern medicine mainly uses steroid drugs as the main treatment method, but it has certain limitations and potential side effects. Traditional Chinese Medicine (TCM) believes that this disease is a syndrome of deficiency in the root cause and excess in the body, with “kidney deficiency with pathogenic stasis” as the core pathogenesis. The disease is caused by kidney deficiency as the root cause, with external pathogenic qi taking advantage of the deficiency and internal pathogenic qi remaining difficult to remove, gradually accumulating and forming tangible solid evil. TCM treatment of this disease emphasizes the cultivation and consolidation of kidney qi to support the upright, as well as the removal of phlegm and blood stasis to eliminate evil, and treats both symptoms and root causes. Traditional Chinese medicine intervention can help to control the condition more stably and prevent recurrence. The article discusses the traditional Chinese medicine understanding and disease treatment ideas of IgG4-RD, and provides a medical case as a reference for the treatment of this disease with traditional Chinese medicine.