基于“五脏之气”论治慢性肾衰竭的研究进展  

Research Progress of Treating Chronic Renal Failure Based on"Qi of Five Zang-Organs"

作　　者：王莉莉 马晓燕[2] WANG Lili;MA Xiaoyan(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;Department of Nephrology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属医院肾病科,沈阳110032

出　　处：《医学综述》2025年第6期711-715,共5页Medical Recapitulate

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)。

摘　　要：慢性肾衰竭(CRF)的病程较长,现代医学多以对症治疗为主。近年来,中医对于治疗CRF及延缓其疾病进展取得诸多进展。中医认为CRF发病根本在肾气亏虚,精微外泄、浊毒内生,加之脾失健运,先后天不足、肺失宣肃,金水不生、肝失疏泄,藏泄失度、心血瘀阻,心肾不交。痰饮、湿浊、瘀毒等病理产物随之产生,故治疗上应从整体入手,基于“五脏之气”理论,结合脏腑辨证,予以补肾益气、健脾化湿、宣肺固表、疏肝行气、活血化瘀之法,更要权衡利弊,顾及相关脏腑之变。未来应从脏腑的生理病理角度出发,深入探讨CRF的病因病机、辨证论治及遣方用药,以期为CRF的临床诊疗提供新思路。Chronic renal failure(CRF)has a long course of disease,and modern medicine mainly focuses on symptomatic treatment.In recent years,traditional Chinese medicine(TCM)has made a lot of progress in the treatment of CRF and delay the progress of the disease.TCM believes that the root cause of CRF is the kidney qi deficiency,subtle leakage,internal turpitude toxin,coupled with loss of spleen health,congenital and acquired deficiencies,lung hypoventilation,insufficient kidney function due to lung dysfunction,liver dysfunction,imbalance of reserving and releasing function,heart blood stasis,and heart-kidney imbalance.The pathological products such as phlegm,dampness and turbidity,stasis and poison are produced accordingly,so the treatment should start from the overall perspective,based on the theory of"the qi of five zang-organs",combined with zang-fu syndrome differentiation,utilizing the method of tonifying kidney and qi,resolving dampness by invigorating spleen,promoting the lungs and reinforcing the surface,soothing liver and promoting qi,activating blood and removing blood stasis,while weighing the advantages and disadvantages,taking into account the changes of related zang-fu organs.In the future,from the point of view of zang-fu physiology and pathology,the etiology,pathogenesis,syndrome differentiation and prescription medication of CRF should be further explored in order to provide new ideas for the clinical diagnosis and treatment of CRF.

关 键 词：慢性肾衰竭 五脏之气 脏腑辨证 

分 类 号：R692.5[医药卫生—泌尿科学]