肖相如治疗慢性肾功能衰竭经验  

Xiao Xiangru's Experience of Treating Chronic Kidney Failure

作　　者：高黎[1] 肖相如[1] 

机构地区：[1]北京中医药大学,北京100029

出　　处：《河南中医》2015年第3期501-502,共2页Henan Traditional Chinese Medicine

摘　　要：慢性肾功能衰竭的本质是气化功能减退,治疗应以恢复人体的气化功能为目的。肖相如教授认为慢性肾功能衰竭的患者多有水湿停留,凡见患者症状不太明显,或有轻度水肿者,其认为湿瘀互结可能是这一时期的主要问题,给予当归芍药散为主治疗;患者内生肌酐清除率下降、血肌酐上升、尿素氮上升者,不论患者有无脾虚的证候,都应在补肾的基础上积极健脾,尤其是在尚无脾虚表现时及时健脾,对保护肾功能具有积极的意义。此时可考虑加用半夏泻心汤、补脾胃泻阴火升阳汤、香砂六君子汤等加减治疗;患者秽浊之邪明显,舌苔厚如积粉,舌质紫绛者,其本质为湿郁化浊,浊郁化毒,毒入血分,给予达原饮合犀角地黄汤为主治疗。The essence of chronic kidney failure is the hypofunction of the qi activity.The treatment should be focused on restoring the function of qi activity.Professor Xiao Xiangru holds that most of the patients with chronic kidney failure have water-damp stagnation even though the symptoms are not obvious.Some patients with slight edema,the mingling of damp and blood stasis is the major problem in this period,and Chinese Angelica and Peony Powder is mainly used for the treatment; for patients with declined endogenous creatinine clearance rate（CCR）,increased serum creatinine and urea nitrogen,the method of strengthening the spleen should be added to tonify the kidney.Especially it is of great significance to timely strengthen the spleen even without manifestation of spleen deficiency for for the purpose of protecting the kidney function.At this time,modified formulas like Pinellia Heart-Draining Decoction,Bupuwei Xieyinhuo Shengyang Decoction（a decoction for tonifying spleen and stomach,purging yin fire and lifting yang）,Costusroot and Amomum Six Gentlemen Decoction can be used for the treatment.For the patients obviously attacked by turbid pathogen with manifestations of thick purple powder-like tongue coating,the root cause is the damp stagnation transforming into turbidity and turbidity further transforming into toxin which later reaches the blood phase.In this case,Membrane Source Opening Decoction combined with Rhinoceros Horn and Rehmannia Decoction is mainly used for the treatment.

关 键 词：慢性肾功能衰竭 当归芍药散 半夏泻心汤 补脾胃泻阴火升阳汤 香砂六君子汤 达原饮 犀角地黄汤 肖相如 

分 类 号：R259.925[医药卫生—中西医结合]