王铁良教授治疗阴虚内热型小儿肾性血尿临床经验

Clinical Experience of Professor Wang Tieliang in Treating Pediatric Renal Hematuria with Yin Deficiency and Internal Heat Syndrome

摘要: 小儿肾性血尿是儿科常见疑难病症，西医治疗手段有限且不良反应较多。本文系统总结了王铁良教授治疗阴虚内热型小儿肾性血尿的临床经验。王教授认为本病总属本虚标实，以肺脾肾三脏亏虚为本，虚火内生、热扰血络为标，治宜调补肺脾肾、寓清于补。临证自拟养阴清热汤，以养阴清肺汤化裁而成，融养阴扶正与清热解毒于一体，标本兼顾。该方适用于多种肾小球疾病所致之阴虚内热证，并可随症灵活加减。现代药理研究证实其具有抗炎、免疫调节及肾脏保护等多靶点作用。验案显示该方能有效改善血尿症状、降低复发率。中医药辨证施治在控制病情、改善预后方面优势显著，值得临床推广应用。

Abstract: Pediatric renal hematuria is a common and refractory disease in pediatrics. Western medicine offers limited therapeutic options and is often associated with numerous adverse reactions. This paper systematically summarizes Professor Wang Tieliang’s clinical experience in treating pediatric renal hematuria characterized by the syndrome of Yin deficiency and internal heat. Professor Wang posits that the pathogenesis of this disease is fundamentally characterized by “root deficiency and branch excess.” The root lies in the deficiency of the Lung, Spleen, and Kidney zang organs, while the branch manifests as endogenous deficient fire generating internally and heat disturbing the blood collaterals. Accordingly, the treatment principle should focus on regulating and tonifying the Lung, Spleen, and Kidney, integrating clearing heat within the strategy of tonification. Based on this principle, Professor Wang formulated the Yangyin Qingre Decoction (Yin-Nourishing and Heat-Clearing Decoction), modified from the classical Yangyin Qingfei Decoction. This formula integrates Yin-nourishing and vital Qi-supporting functions with heat-clearing and toxin-resolving effects, thereby addressing both the root and the branch simultaneously. It is applicable to the syndrome of Yin deficiency and internal heat caused by various glomerular diseases and allows for flexible modification according to specific clinical manifestations. Modern pharmacological studies have confirmed that this decoction exerts multi-target effects, including anti-inflammatory activity, immunomodulation, and renal protection. Clinical case reports demonstrate that this formula can effectively alleviate hematuria symptoms and reduce recurrence rates. Traditional Chinese Medicine (TCM) treatment based on syndrome differentiation shows significant advantages in controlling the disease and improving prognosis, warranting wider clinical application and promotion.