经方枳术汤合柴胡桂枝干姜汤、五苓散治疗慢性肾功能不全水肿  

Chronic Renal Failure Edema Treated by Zhizhu Decoction(枳术汤)Combined with Chaihu Guizhi Ganjiang Decoction(柴胡桂枝干姜汤)and Wuling Powder(五苓散)

作　　者：裴育莹 荣小龙 李步满 PEI Yuying;RONG Xiaolong;LI Buman(Tsinghua University Yuquan Hospital(Tsinghua University Hospital of Integrated Traditional Chinese and Western Medicine),Beijing 100040,China)

机构地区：[1]清华大学玉泉医院(清华大学中西医结合医院),北京100040

出　　处：《辽宁中医药大学学报》2024年第5期167-169,共3页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：吕仁和名老中医工作室清华大学玉泉医院(清华大学中西医结合医院)分站建设项目(京中医科字[2022]111号)。

摘　　要：慢性肾功能不全(chronic renal failure,CRF)是指各种慢性肾脏病进展引起的肾单位和肾功能不可逆地丧失,临床表现十分复杂,中医根据其临床表现将其归属于“虚劳”“水肿”“癃闭”“关格”“溺毒”等范畴。该文介绍李步满教授运用经方枳术汤合柴胡桂枝干姜汤、五苓散治疗CRF水肿的一则验案。通过对验案的分析,使广大读者深入认识CRF水肿的病证特点,结合古代各医家对方药的阐述及临床应用,系统分析CRF水肿临证处方思路,为临床治疗CRF水肿开拓思路。对于疑难病的临床治疗,李步满教授强调要谨守病机,各司其所,以扶正祛邪为治疗原则,在治疗时需注意顾护脾胃之气。Chronic renal failure(CRF)refers to the irreversible loss of nephron and renal function caused by the progression of various chronic kidney diseases(CKD).The clinical manifestations of CRF are very complex.According to the clinical manifestations,it belongs to the categories of“asthenia”“edema”“closure”“drowning”etc.This article introduces Professor LI Buman's experimental case of treating CRF edema with Zhizhu Decoction(枳术汤),Chaihu Guizhi Ganjiang Decoction(柴胡桂枝干姜汤)and Wuling Powder(五苓散).Through the analysis of the experimental case,the readers have a deep understanding of the characteristics of CRF edema.Combined with the explanation and clinical application of ancient doctors,the clinical prescription ideas of CRF edema are systematically analyzed,so as to open up ideas for clinical treatment of chronic renal insufficiency edema.For the clinical treatment of difficult diseases,Professor LI Buman emphasizes that the pathogenesis should be obeyed,the department should be different.We should take strengthening health and expelling pathogenic factors as the treatment principle,and pay attention to the Qi of the spleen and stomach during the treatment.

关 键 词：慢性肾功能不全 水肿 枳术汤 柴胡桂枝干姜汤 五苓散 

分 类 号：R256.5[医药卫生—中医内科学]