基于“虚气留滞”理论辨治Ⅱ型心肾综合征进展  

Progress of Treatment of TypeⅡCardio-renal Syndrome Based on the Theory of“Deficiency of Qi Stagnation”

作　　者：廉坤 姚涛[2] 杨梦[1] 张君宇 谈宇权 胡志希[1] LIAN Kun;YAO Tao;YANG Meng;ZHANG Junyu;TAN Yuquan;HU Zhixi(Hunan University of Chinese Medicine,Changsha 410208,China;Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]河南中医药大学,河南郑州450046

出　　处：《中国中医药信息杂志》2022年第12期147-151,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金(81774208);湖南省自然科学基金(2020JJ4062、2019JJ50447、2020JJ5408);广东省重点领域研发计划(2020B1111100001);湖南省教育厅优秀青年项目(18B235);湖南中医药大学校级科研基金(2017XJJJ12、2019XJJJ012)。

摘　　要：Ⅱ型心肾综合征是慢性心力衰竭所致慢性进行性肾脏病,严重时会出现心肾功能衰竭,是本领域的研究热点和难点。因其病理机制复杂,给临床治疗带来困难。本病主要病机为本虚——“虚气”(心肾两虚)和标实——“留滞”(痰浊瘀毒)相互胶着、互为因果,呈螺旋式进展,并形成恶性循环,贯穿疾病发展过程。疾病初期以“虚气”为主,中期二者并重,后期以“留滞”为重。以益气温阳、活血利水为基本治法,初期温阳、益气、补肾、强心、中期则标本兼治、扶正祛邪,后期以活血化瘀、利水降浊、化痰解毒之法为主。本文梳理近年来对Ⅱ型心肾综合征中医辨治进展,以期为临床治疗提供借鉴。TypeⅡcardio-renal syndrome is a chronic progressive kidney disease caused by chronic heart failure,and cardiac-renal failure may occur in severe cases,which is a research hotspot and difficulty in this field.This brings difficulties to clinical treatment because of its complex pathological mechanism.The main pathogenesis of this disease is deficiency in essence-“deficient qi”(heart and kidney deficiency)and excess in symptoms-“stagnation”(phlegm turbid,stasis and poison)mutually mix,and become mutual cause and effect,with a spiral progress,which forms a vicious cycle and goes through the development of the disease.In the early stage of the disease,“deficient qi”is the main factor,both are important in the middle stage,and“qi stagnation”is the main factor in the late stage.Therefore,tonifying qi and warming yang,and activating blood circulation and increasing urine excretion were the basis treatment methods.In the early stage,warming yang,tonifying qi,tonifying kidney,and strengthening heart would be the basic treatment methods;in the middle stage,treating both manifestation and root cause of disease strengthening vital qi to eliminate pathogenic factors would be the method;in the later stage,activating blood circulation and reducing stasis,increasing urine excretion and descending turbid,and reducing phlegm and removing toxic materials would be the basic treatment methods.This article reviewed the progress of TCM differentiation and treatment of typeⅡcardio-renal syndrome in recent years,in order to provide reference for clinical treatment.

关 键 词：虚气留滞 心肾综合征 益气温阳 心肾不交 中医药疗法 综述 

分 类 号：R259.416.1[医药卫生—中西医结合] R277.522.5[医药卫生—中医内科学]