聂莉芳治疗慢性肾衰竭经验  

NIE Lifang’s Experience in Treatment of Chronic Renal Failure

作　　者：王耀巍 董菲[1] 徐建龙[1] 余仁欢[1] WANG Yaowei;DONG Fei;XU Jianlong;YU Renhuan(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《山东中医杂志》2025年第4期373-377,400,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：中国中医科学院西苑医院名老中医传承项目(编号:XYZX0101-35,XYZX0101-22)。

摘　　要：聂莉芳教授认为慢性肾衰竭属中医学关格范畴,并将其分为虚损期、关格期两期,提出了辨病、辨病期、辨证、辨症相结合的中医辨治模式。聂教授认为关格的病因主要为素体脾肾虚损、正气耗伤,感受外邪及过劳后诱发。病机为多脏受累,正虚邪实,虚实夹杂。在治疗过程中既重视标本缓急,抓主症,又谨守病机注重守方,还重视脏腑生克承制和正邪变化,防传变。以慢性肾衰竭的虚损期、关格期临床常见证型为主线,及时处理慢性肾衰竭的常见并发症,有守有变,常获良效。验案以佐证之。Professor NIE Lifang believes that chronic renal failure falls under the category of obstruction and repulsion in traditional Chinese medicine(TCM),and she divides it into two stages:deficiency and damage stage and obstruction and repulsion stage,and puts forward a TCM diagnostic and therapeutic model that combines disease differentiation,phase differentiation,syndrome differentiation and symptom differentiation.Professor NIE believes that the primary causes of obstruction and repulsion are the inherent deficiency of the spleen and kidney,the depletion of the body’s vital energy,and the subsequent invasion of external pathogens or overwork.The pathogenesis involves multiple organ systems being affected,asthenia healthy qi and sthenia pathogenic factor and a combination of deficiency and excess.In the treatment process,equal importance is given to addressing both the root causes and the symptoms,adhering to the underlying pathogenic mechanisms while maintaining a consistent treatment regimen.Additionally,there is an emphasis on the relationships between the organs and the changes in the balance between the body’s healthy state and pathogenic factors,preventing the progression of the disease.Focusing on the common syndrome types during the deficiency and obstruction and repulsion stages of chronic renal failure as the main line,timely management of common complications of chronic renal failure,balancing consistency and adaptability in treatment often achieve good results positive outcomes,which are further proved by clinical case studies.

关 键 词：慢性肾衰竭 辨病论治 辨证论治 虚损期 关格期 聂莉芳 

分 类 号：R277.525[医药卫生—中医学]