再谈慢性肾功能衰竭的治疗经验

Further discussion on experience in treating chronic renal failure

笔者曾多次探讨慢性肾衰的治疗问题,近年又有一些新的认识。关于病机可概括为:气化功能逐渐减退乃至丧失、湿邪停留、湿邪化浊、湿浊化毒、毒入血分。关于治疗应从正虚邪实两方面考虑:扶正应以恢复人体的气化功能为目的,具体方法可参照笔者提出的"慢性肾功能衰竭的整体功能代偿疗法"。祛邪的方法可补充以下3条:①凡症状不太明显,或有轻度水肿者,可以当归芍药散为主治疗;②湿热明显,舌苔黄腻者,可以半夏泻心汤为主治疗;③秽浊之邪明显,舌苔厚如积粉,舌质紫绛者,可以达原饮合犀角地黄汤为主治疗。

For many times,I have discussed issues of therapy for chronic renal failure.Further,I have some new insights into it in recent years.To summarize pathogenesis,it includes decrease or even loss of normal function of vital-qi,retention of damp pathogen,conversion of damp pathogen into turbid pathogen,conversion of turbid pathogen into toxin,and toxin invasion of blood system.As for therapy,both vital-qi deficiency and pathogen sufficiency should be considered.For supporting vital-qi to restore the normal function of it,please refer to my ＇integrated functional compensation therapy for chronic renal failure＇ for specific treatment.For eliminating pathogen,I would like to add several points as follows.① For patients without obvious symptoms or with mild edema,use Dang-Gui-Shao-Yao Powder as primary medication.② For those with obvious damp-heat and yellow sticky tongue fur,use Banxia Xiexin Decoction as primary medication.③ For those with obvious filthy turbid pathogen,thick powder-like tongue fur and purple-crimson tongue,use Da-Yuan Decoction combined with Xijiao Dihuang Decoction as primary medication.