郭恩绵教授以湿浊毒邪论治虚劳水气病  

Professor GUO Enmian's theory of dampness and turbid toxin in the treatment of consumptive renal failure

作　　者：包帅 郭玲[1] BAO Shuai

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中医临床研究》2024年第4期109-113,共5页Clinical Journal Of Chinese Medicine

基　　金：2021辽宁省中医大师传承工作室建设项目。

摘　　要：慢性肾功能衰竭是多种肾脏疾病的晚期转归,也是高血压肾损害及糖尿病肾损害的最终结局。慢性肾功能衰竭临床多见慢性虚弱综合征,可累及多个系统及脏器。在此病的治疗中,中西医结合疗法可延缓患者进入维持性血液透析的时间,提高患者生活质量。郭恩绵教授从事肾脏病临床诊疗五十余年,对慢性肾功能衰竭的病因病机及治疗具有深刻体会,郭恩绵教授根据《金匮要略》水气病及脏腑虚损证候将慢性肾功能衰竭命名为虚劳水气病,提出该病病机为“正虚毒蕴”,以脾肾亏虚为本,邪毒内蕴为标。临床以湿浊毒邪为其致病因素,且此湿浊毒邪具有毒剧、根深、内伏之特性,致此病难愈,并基于此提出解毒泄浊之法,采用多途径治疗、多脏腑同治,自拟肾衰方口服、降氮煎灌肠等方法,对虚劳水气病形成了比较系统的治疗方案,对于延缓慢性肾功能衰竭的进展及缓解患者不适症状起到一定疗效。Chronic renal failure is the late outcome of many kinds of kidney diseases,and it is also the final outcome of hypertensive kidney damage and diabetic kidney damage.Chronic frailty syndrome is common in chronic renal failure,which may involve multiple systems and organs.In the treatment of this disease,the combination of traditional Chinese medicine and Western medicine can delay the time of patients entering maintenance hemodialysis and improve the quality of life of patients.Professor GUO Enmian has been engaged in the clinical diagnosis and treatment of kidney disease for more than 50 years,and has a deep understanding of the etiology,pathogenesis and treatment of chronic kidney failure.Professor GUO Enmian named chronic kidney failure as consumptive edema disease according to the syndrome of renal failure and Zangfu(脏腑) deficiency in Jingui Yaolue(《金匮要略》).It is suggested that the pathogenesis of this disease is “positive deficiency and toxic accumulation”,which is based on the deficiency of spleen and kidney and is marked by the pathogenic toxic accumulation.Clinically,dampness turbidity toxin is the pathogenic factor,and it is proposed that this dampness turbidity toxin has the characteristics of severe toxicity,deep root and internal disease,which makes this disease difficult to cure.Based on this,the method of detoxification and turbidity drainage is proposed,and the methods of multi-channel treatment,multiple viscera treatment,the self-designed Shenshuai prescription(肾 衰 方) and enema with the Jiangdan decoction(降 氮 煎) are adopted to form a relatively systematic treatment plan for the disease.It can delay the progression of chronic renal failure and relieve the discomfort of patients.

关 键 词：湿浊毒邪 肾衰方 降氮煎 名家经验 

分 类 号：R256.5[医药卫生—中医内科学]