基于“虚则补之”理论探讨慢性肾功能衰竭中医药治疗  

Discussion on the Treatment of Chronic Renal Failure with Traditional Chinese Medicine Based on the Theory of“Deficiency Makes up for Deficiency”

作　　者：陈志远 张晶晶[2] 付彤童 张欣宇 冯国庆 王祥生 Chen Zhiyuan;Zhang Jingjing;Fu Tongtong;Zhang Xinyu;Feng Guoqing;Wang Xiangsheng(Jining Hospital,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Jining 272000,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100000,China;The Hospital Affiliated to Jining Medical University,Jining 272000,China)

机构地区：[1]中国中医科学院西苑医院济宁医院,山东济宁272000 [2]中国中医科学院西苑医院,北京100000 [3]济宁医学院附属医院,山东济宁272000

出　　处：《亚太传统医药》2025年第2期193-197,共5页Asia-Pacific Traditional Medicine

基　　金：国家中医药管理局科技项目(GZY-KJS-SD-2023-027)。

摘　　要：慢性肾功能衰竭病变过程中虚实夹杂,其病机关键是肾气先天不足,脾失先天充养,气虚日久致脾肾阳虚,辨证当从脾肾气虚为入手。现基于《黄帝内经》“虚则补之”理论探讨慢性肾功能衰竭的中医治疗方案,总结历代医家从“虚”论治慢性肾功能衰竭辨证及用药经验,多数医家认为该病病变之初以气虚为主,气虚无力运化湿浊,日久化瘀成毒,衍变为虚实夹杂且以虚为主,治疗当从脾、肾两脏入手,遣方用药强调补虚泻实,具体处方选用四君子汤、参芪地黄汤、温脾汤、右归丸,单味药选用冬虫夏草、黄芪、党参、当归、熟地黄、附子等。慢性肾功能衰竭临床治疗应从更多角度探讨补虚之法,从脾肾、气血、阴阳等不同角度选方用药各有侧重,并注意不能妄补,基于辨证用药,补中有泻。In the course of chronic renal failure,deficiency,and excess are mixed,but the key to pathogenesis is a congenital deficiency of kidney-qi,deficiency of spleen-qi leads to deficiency of spleen-yang and kidney-yang,based on the theory of“Deficiency is beneficial to the Huangdi Neijing”,now discusses the therapeutic scheme of traditional Chinese medicine for chronic renal failure(CRF),most doctors think that the disease is mainly caused by deficiency of Qi at the beginning,and the deficiency of Qi can not transport dampness and turbidity,and it becomes toxic after a long time,the prescription emphasizes tonifying deficiency and reducing excess.The specific prescription is sijunzi decoction,Shenqi Dihuang decoction,Wenpi decoction,and Yougui pill,single herbs include ophiocordyceps sinensis,astragalus,codonopsis pilosula,angelica sinensis,radix rehmanniae,and radix aconiti lateralis.The clinical treatment of chronic renal failure should explore the method of tonifying deficiency from more angles,and choose the prescription from different angles,such as spleen and kidney Qi,blood,yin and yang,etc.

关 键 词：慢性肾功能衰竭 虚则补之 辨证论治 中医疗法 

分 类 号：R256.5[医药卫生—中医内科学]