慢性肾脏病蛋白质能量消耗的中医药治疗进展  

A review on in TCM therapy of protein-energy wasting in chronic kidney disease

作　　者：张芳芳[1] 王素芹[1] Zhang Fangfang;Wang Suqin

机构地区：[1]南京中医药大学附属淮安中医院,江苏淮安223001

出　　处：《中医临床研究》2021年第27期142-145,共4页Clinical Journal Of Chinese Medicine

摘　　要：蛋白质能量消耗(Protein-energy Wasting,PEW)是慢性肾脏病(Chronic Kidney Disease,CKD)重要的并发症之一,是在CKD进展过程中伴随的体内蛋白质和能量储备下降的状态,与CKD疾病进展、终点事件有着密切的关系,增加了CKD患者的住院率及病死率,影响患者的预后,加强对CKD患者PEW的研究,意义重大。根据其发病的临床症状,神疲乏力、气短懒言、纳谷减少、肌肉消瘦、面色萎黄、腰膝酸软、大便溏、恶心、呕吐等症状,临床合并的尿毒素和微炎症因子,中医将其归属中医学"虚劳""肌痿"等病证范畴进行讨论。PEW病机总属脏腑亏虚、浊毒内停,其脏腑亏虚主要为脾肾亏虚,涉及肺、肝,其标证主要是水湿、浊毒、痰瘀。PEW的治疗从补虚祛邪入手,强调培补先后天之本,祛除痰、浊、瘀之邪。近年来中医药在PEW的研究比较多。文章从病因病机、治则治法、辨证论治、复方治疗、单方验方、外治法、实验研究等方面对慢性肾脏病蛋白质能量消耗近年来中医药研究进展进行综述。中药治疗CKD-PEW临床疗效好,改善了PEW的临床症状和营养状况,值得临床推广。One of the important complications of chronic kidney disease is protein-energy wasting(PEW).The decline of protein and energy reserves during the progression of chronic kidney disease(CKD)is closely related to the progression of CKD and the end-point events.It increases the hospitalization rate and mortality of CKD patients,and affects the prognosis of patients.It is necessary to strengthen the study of PEW in CKD patients.These future studies have important research significance.According to the clinical symptoms,such as fatigue,shortness of breath,lack of appetite,muscle wasting,pale complexion,weak waist and knee,loose stool,nausea and vomiting,and urinary toxin and micro inflammatory factors in clinical practice,Traditional Chinese medicine classifies them into the category of deficiency fatigue and muscular flaccidity in traditional Chinese medicine.The pathogenesis of PEW always belongs to deficiency of viscera and stagnation of turbid toxin.The deficiency of viscera is mainly spleen and kidney deficiency,involving lung and liver,and its standard syndromes are mainly water dampness,turbid toxin and phlegm stasis.The treatment of PEW starts with tonifying deficiency and removing pathogenic factors,emphasizing the cultivation of the foundation of healthy qi and eliminating the pathogenic factors of phlegm,turbidity and blood stasis.In recent years,there are more traditional Chinese medicine researches on PEW.This paper reviews the research progress of protein-energy wasting in chronic kidney disease in recent years from the aspects of etiology and pathogenesis,treatment principle and treatment method,syndrome differentiation and treatment,compound treatment,single prescription and tested prescription,external treatment and experimental research.Chinese medicine has good clinical efficacy in the treatment of CKD-PEW,which relieves the clinical symptoms and improves nutritional status of PEW.It is worthy of clinical promotion.

关 键 词：慢性肾脏病 蛋白质能量消耗 中医药研究 综述 

分 类 号：R256.5[医药卫生—中医内科学]