狼疮性肾炎是系统性红斑狼疮最常见且最严重的并发症，也是导致终末期肾病的重要原因。王耀光教授结合临床经验认为狼疮性肾炎的核心病机为本虚标实，即以脾肾亏虚、气化不利为本，水湿、瘀血、痰浊搏结成形为标。在整个病程演变过程中，可划分为急性活动期、迁延转化期及慢性硬化衰竭期三个阶段。各期病机侧重点不同，治疗时应遵循分期辨治、动态调整的原则：急性活动期以清热解毒，凉血散结为主；迁延转化期注重健脾益肾，活血利湿；慢性硬化衰竭期则强调温肾化气，削癥通络削坚散结、通络，并适时选用虫类药以增强通络化瘀之效，以期达到控制疾病活动、减少复发、延缓疾病进展的目的。本文总结并体现了本文中医药在狼疮性肾炎治疗中的优势，为临床提供了一套较为完整的诊疗思路。

       Lupus nephritis（LN）is the most common and serious complication of systemic lupus erythematosus（SLE）and a significant cause of end-stage renal disease．Based on his extensive clinical experience，Professor Wang Yaoguang proposes that the core pathogenesis of LN is characterized by a deficiency-root and excess-manifestation pattern．This manifests as spleen and kidney deficiency with impaired qi transformation as the root deficiency，while the combination of water-dampness，blood stasis，and phlegm-turbidity coalescing constitutes the manifest excess．The disease progression can be divided into three stages：the acute active phase，the protracted transformation phase，and the chronic sclerosing and failure phase．The pathological focus differs at each stage，necessitating stage-differentiated pattern identification and treatment and dynamic therapeutic adjustments．During the acute active phase，the treatment principle focuses primarily on clearing heat and resolving toxicity，and cooling blood to disperse nodules．The protracted transformation phase emphasizes fortifying the spleen and tonifying the kidney，combined with activating blood and draining dampness．In the chronic sclerosing and failure phase，the strategy shifts to warming the kidney，transforming qi and softening hardness，dispersing nodules，and unblocking collaterals；the timely application of insect drugs is also adopted to enhance the effect of unblocking collaterals and transforming stasis．This approach aims to control disease activity，reduce relapse，and delay progression．This approach highlights the advantages of traditional Chinese medicine in managing LN and providing a relatively comprehensive diagnostic and therapeutic framework for clinical practice．

       淋证是临床常见病证，病情易迁延、反复，现代医学以抗生素治疗为主，但面临耐药与易复发等困境，严重影响患者生活质量。中医认为，其核心病机在于“大气失转，枢机不利”，导致三焦水道壅滞，肾与膀胱气化功能失常，病位虽在下焦，实则与肺、肝、胆、心、脾、肾等多脏腑功能密切相关。治疗应以“疏利少阳，运转大气”为基本治则，以小柴胡汤为基础方和解枢机，并随证配伍清热利湿、温肾化气、健脾固本等法，旨在恢复三焦气化与水液代谢功能，以达到“大气复转，水道自通”之效。该治法体现了中医从整体出发、标本兼治的辨证思想，为淋证的临床诊治提供参考。

       Strangury is a common clinical disease characterized by its persistent and recurrent course．Modern medicine primarily employs antibiotic therapy，yet challenges such as drug resistance and high recurrence rates remain，significantly affecting patients’ quality of life．In traditional Chinese medicine（TCM），its core pathogenesis involves “impaired movement of the Great Qi and obstruction of the pivotal mechanism”，which leads to stagnation of the Sanjiao water passages and dysfunction of qi transformation in the kidney and bladder．Although the disease is located in the lower Jiao，it is closely related to dysfunction of multiple organs，including the lung，liver，gallbladder，heart，spleen，and kidney．The treatment should follow the principle of “soothing and promoting Shaoyang，circulating Great Qi．” Xiaochaihu Decoction is used as the basic formula to harmonize the pivot mechanism，supplemented with therapies such as clearing heat and draining dampness，warming the kidney to promote qi transformation，and strengthening the spleen to consolidate the root，based on syndrome differentiation．This aims to restore the qi transformation function of the Sanjiao and water metabolism，thereby achieving the therapeutic goal of “restoring the movement of Great Qi and freeing the water passages．” This approach reflects TCM’s holistic concept and its dialectical thinking of addressing both root and branch，providing a reference for the clinical diagnosis and treatment of strangury．