杨曙东运用温法治疗慢性肾脏病经验  

YANG Shudong’s Experience in Treatment of Chronic Kidney Disease with Warming Method

作　　者：陈玉链 何日明[2] 罗粤铭 卢建东[2] 杨曙东(指导) CHEN Yulian;HE Riming;LUO Yueming;LU Jiandong;YANG Shudong(Mentor)(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033,China;Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,China;不详)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033 [3]不详

出　　处：《山东中医杂志》2023年第7期756-759,共4页Shandong Journal of Traditional Chinese Medicine

基　　金：广东省自然科学基金项目(编号:2020A1515011151);深圳市基础研究专项(自然科学基金)项目(编号:JCYJ20180302173708520)。

摘　　要：杨曙东教授认为慢性肾脏病的病机以脾肾阳虚为本,湿浊、瘀血壅扰为标,治疗应以温法为主,再根据患者舌、脉、症状变化,辅以清、消、补等法。针对脾肾阳虚,治以辛热扶阳、甘温补气,处方常用金匮肾气丸、补中益气汤、四君子汤等;针对寒湿表证,治以温阳散寒,处方常用麻黄加白术汤、白术附子汤、桂枝附子汤等;针对水湿痰瘀,治以温清并用,根据三焦病位选择相应药物;针对瘀血,治以温阳化瘀,处方多以黄芪桂枝五物汤、桃红四物汤加减。附验案一则。Professor YANG Shudong believes that the principal pathogenesis of chronic kidney disease is yang deficiency of spleen and kidney,and secondary aspect of the pathogenesis is disturbance by turbid dampness and blood stasis.Therefore,warming method should be taken as the essential treatment method for chronic kidney disease,supplemented by clearing,eliminating and tonifying methods according to the changes of the patients’tongue,pulse and symptoms.For treating yang deficiency of spleen and kidney,medicinals with pungent and warm property are often used to strengthen yang,medicinals with sweet and warm property are often used to invigorate qi,and Jingui Shenqi Pills(金匮肾气丸),Buzhong Yiqi Decoction(补中益气汤),Sijunzi Decoction(四君子汤)are the commonly used prescriptions.For treating exterior cold-dampness syndrome,prescriptions with the function of warming yang and dispelling cold,such as Mahuang Jia Baizhu Decoction(麻黄加白术汤),Baizhu Fuzi Decoction(白术附子汤),Guizhi Fuzi Decoction(桂枝附子汤),are often used.On account of the accumulation of water-dampness,phlegm,and blood stasis,the warming method and clearing method are applied simultaneously,and the corresponding medicinals are selected according to the disease location in triple energizer.For blood stasis,prescriptions with the function of warming yang and resolving blood stasis,such as Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤)and Taohong Siwu Decoction(桃红四物汤),are often modified according to the patients’personal condition.A proved case is listed.

关 键 词：慢性肾脏病 温法 辛热扶阳 甘温补气 温阳化瘀 杨曙东 

分 类 号：R277.5[医药卫生—中医学] R249