张仲景虚劳病学术思想对血透患者虚弱综合征的诊疗指导

Diagnosis and treatment of frailty in hemodialysis patients guided by ZHANG Zhong-jing's academic thought on asthenic disease

虚弱综合征是以个体生理储备减少以及对应激脆弱性增加为特点的一种医学综合征,在血透患者中较为常见。可将其归为中医"虚劳病"的范畴。文章通过探讨张仲景对虚劳病病因病机及治疗方法的认识,指导血透患者虚弱综合征的临床诊治。本病病因病机主要是精、气、血、津液、阴阳的不足,病位主要在脾肾,且易感受外邪,内生瘀血;治疗上主要以温阳益气,补脾建中为主,注重甘味药的运用。

Frailty is a medical syndrome characterized by reduced individual physiological reserves and increased vulnerability to stress, which is more common in hemodialysis patients. It can be classified as ‘asthenic disease＇ in Chinese medicine category. We discussed ZHANG Zhong-jing＇s understanding of the pathogenesis and treatment of asthenic disease to guide the clinical diagnosis and treatment of frailty in hemodialysis patients. The pathogenesis of frailty is mainly the deficiency of essence, gas, blood, body fluid, yin and yang, and the main disease sites are in the spleen and kidney. The asthenic patients are also susceptible to exogenous pathogens and endogenous blood stasis. Its treatment is mainly aimed to warm yang and benefit qi, nourish spleen and middle energizer. We should also pay attention to the use of sweet medicine.