何学红运用参芪泄浊饮治疗慢性肾功能衰竭经验  

He Xuehong′s Experience of Treating Chronic Renal Failure with Ginseng and Astragalus Turbidity-Resolving Beverage

作　　者：赵娜 何学红[2] ZHAO Na;HE Xuehong(Qigong Community Health Service Center of Tiexi District in Shenyang,Shenyang,Liaoning,China,110020;The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning,China,110032)

机构地区：[1]沈阳市铁西区启工社区卫生服务中心,辽宁沈阳110020 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《河南中医》2024年第12期1861-1865,共5页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家经验传承工作室建设项目{国中医药人教函[2022]75号}。

摘　　要：何学红教授认为,慢性肾功能衰竭的病因病机为脾肾虚衰,多脏受累;湿浊内停,阻遏气机;尿毒积蓄,血络瘀阻;内毒横暴,变由毒出。何教授治疗慢性肾功能衰竭以泄浊补虚为核心,注重急治标、缓治本,复气化、促湿化,利水湿、泄浊毒,化瘀法、贯始终。何教授认为,早期治疗以补肾健脾,活血利湿为主;中后期症状复杂,但核心本质不离,故以参芪泄浊饮健脾益肾、化瘀解毒、通腑泄浊为主补虚泻实。气虚甚者,重用黄芪,加党参补气固本;阴虚甚者,重用山药,加二至丸滋阴补肾;阳虚甚者,重用山茱萸,加菟丝子、补骨脂补肾助阳;湿盛者,可加大砂仁、藿香、佩兰的用量芳香化湿。此外,何教授还提倡配合大黄灌肠泄浊、药浴发汗散浊、药物敷脐祛浊等中医特色外治疗法。Professor He Xuehong believes that the etiology and pathogenesis of chronic renal failure(CRF)are characterized by spleen and kidney deficiency,with multiple organs involved;the internal stagnation of dampness and turbidity,obstructing the flow of qi movement;the accumulation of uremic toxins leading to blood stasis and blockage of blood vessels;and the overflow of internal toxins exacerbating the condition.Professor He′s treatment focuses on resolving turbidity and tonifying deficiency,with an emphasis on treating acute symptoms promptly and addressing the root cause in chronic stages.The treatment principles involve restoring qi transformation,promoting fluid transformation,clearing dampness,eliminating turbidity toxins,and activating blood circulation.In the early stage of CRF,the focus is on tonifying the kidney and invigorating the spleen,promoting blood circulation,and removing dampness.In the later stages,symptoms become more complex,but the core pathology remains unchanged,so Ginseng and Astragalus Turbidity-Resolving Beverage is used to tonify the spleen and kidney,resolve stasis,eliminate toxins,promote smooth bowel movement,nourish deficiency and purge excess.For severe qi deficiency,Huangqi(Radix Scutellariae)is heavily used,and Dangshen(Radix Codonopsis)is added to strengthen qi and support the foundation.For severe yin deficiency,Shanyao(Rhizoma Dioscoreae)is heavily used,and Double Supreme Pill is added to nourish yin and tonify the kidney.For severe yang deficiency,Shanyurou(Fructus Corni)is heavily used,Tusizi(Semen Cuscutae)and Buguzhi(Fructus Psoraleae)are added to tonify the kidney and support yang.For excessive dampness,Sharen(Fructus Amomi),Huoxiang(Herba PogoStemonis)and Peilan(Herba Eupatorii)can be used in higher doses to promote the aromatic transformation of dampness.Additionally,Professor He advocates complementary external therapies such as Dahuang(Radix et Rhizoma Rhei)enema to clear turbidity,medicinal baths to induce sweating and expel toxins,and herbal poultices applied to the n

关 键 词：慢性肾功能衰竭 参芪泄浊饮 大黄 药浴疗法 敷脐疗法 何学红 

分 类 号：R259.925[医药卫生—中西医结合]