李顺民“健脾益肾二补五通”法治疗慢性肾衰经验总结  

Treatment of chronic renal failure by “tonifying spleen and kidney with five promotions”: Prof. Li Shun-min’s experience

作　　者：李雨彦[1] 林韦翰 李顺民[1] LI Yu-yan;LIN Wei Han;LI Shun-min(Shenzhen Traditional Chinese Medicine Hospital,Shenzhen Guangdong 518033)

机构地区：[1]深圳市中医院

出　　处：《世界中西医结合杂志》2019年第11期1519-1522,1538,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目(20191278)

摘　　要：李顺民教授从事中医肾病临床教学科研40多年,临床诊疗经验丰富。李教授认为慢性肾衰早中晚期的临床表现主要以脾胃化生气血功能异常为主,基本病机以脾肾气虚为本,湿瘀浊毒为标。治疗应精准把握本虚标实、脾虚气血生化乏源这一主要矛盾,倡导肾病从脾论治,补土生水,打通泄浊通路,祛湿化瘀排浊毒,主张“健脾益肾,二补五通”,即补脾补肾,通大便,通小便,通汗液,通呼吸,通血脉。只有脾旺土肥,胃气强健,气血生化有源,肾之精气得以充养,肾之气化功能才能正常发挥。只要脾肾功能正常,则大便顺,小便调;肺气宣,呼吸畅;心气足,血脉通。二补以固本,五通以祛邪。正气驱毒外出,邪去则正安。临床应用表明,该法对慢性肾衰的保健和康复有明显的治疗、阻断与延缓作用,可供同道借鉴和探讨。Prof.Li Shun-min has rich experience in TCM nephropathy with more than 40 years′clinical research and teaching.He thought that the symptoms of chronic renal failure in all stages mainly manifested as dysfunction of spleen and stomach in transforming qi and generating blood.The mechanism was spleen and kidney qi deficiency as the root and dampness turbidity stasis and toxin as the branch.Treatment should be focused on the main pathogenesis of deficiency of the root and excess of the branch,more accurately,insufficiency of source of qi and blood generation due to spleen deficiency.Therefore,the main treatment was nourishing earth to generate water,dredging passage to remove dampness,resolve stasis and expel toxin by“tonifying spleen and kidney with five promotions”,meaning tonifying spleen and kidney and the promotion of bowels,urination,sweat,breath and blood.Normal function of the spleen and stomach were the essential factors of qi and blood generation and transformation,thus,kidney qi can be nourished leading to a normal function of the kidney,so as to regulate bowel movement,urination,breathing and blood circulation.The spleen and kidney were tonified to reinforce the root and five promotions were made to eliminate pathogenic factors.Healthy qi can expel toxin and the body can restore health.Clinical researches have shown that this method could be applied to the treatment of chronic renal failure with a remarkable effect.

关 键 词：慢性肾衰 健脾益肾 扶正 祛邪 

分 类 号：R692.5[医药卫生—泌尿科学]