中医辨治慢性肾脏病呕吐探析

Approach to TCM syndrome differentiation and treatment of chronic kidney disease-induced vomiting

慢性肾脏病所引起的呕吐等消化道症状多为慢性肾脏病终末期患者的突出表现,也可见于慢性肾脏病其它病程阶段。该病病机可概括为肺脾肾功能失司,水液运化失常;或肾元衰惫,冲气上逆;或肝失疏泄,胃失和降。中医治疗包括健脾化湿、和胃止呕,温补肾阳、化气行水,补益肾气、平冲降逆,疏肝解郁、和胃止呕,肃肺降逆等。临床治疗该病应辨证论治、准确选方,辅以不同中医药疗法以提高疗效。

The digestive tract symptoms caused by chronic kidney disease,such as vomiting etc.are mostly glaring manifestations in end-stage of chronic kidney disease of patients,can also occur in other stages of course of chronic kidney disease.The pathogenesis of this disease can be summarized as follow:dysfunction of lung,spleen and kidney;abnormal transportation and transformation of body fluid;or the congenital kidney dificiency,Chong Qi adversely ascending;or liver disfunction stomach-qi descending abnormally.The therapy of TCM includes as follows:invigorating spleen for eliminating dampness and stomach-harmonizing for arresting vomiting;nourishing and warming kidneyyang and activating qi for promoting transportation and transformation of body fluid;invigorating kidney qi and making adverse-ascending qi downwards;soothing the live for dispelling stagnated liver-qi and stomach-harmonizing for arresting vomiting;descending liver-qi for descending stomach-qi,etc.The clinical treatment of this disease should be based on analysis of syndrome differentiation,accurate selection of recipes as well as supplement by different therapies of TCM,so as to improve the curative effect.