阮诗玮教授治疗尿毒症性皮肤瘙痒经验

Professor Ruan Shiwei's Clinical Experience in Treating Uremic Pruritus

尿毒症性皮肤瘙痒是慢性肾衰竭尿毒症常见并发症之一,临床发病率高。阮诗玮教授根据长期中医临证实践经验并结合现代相关研究,系统地总结了尿毒症性皮肤瘙痒疾病的中医学认识及临证治疗经验,指出其病因病机当基于尿毒症基本病理状态,以内生浊毒之邪、津气血亏虚为内在因素,四时六淫邪气为诱发因素,基本病机即为浊毒内蕴、毒邪外发,津血亏虚、肌肤失养。根据其病机特点总结临床辨证要点为"虚、热、毒、郁",并创设性提出了"补、清、下、汗"四大治疗法则。同时,临床治疗以分期辨证论治,并归纳其急性期、慢性期及慢性迁延期的临床表现及理法方药,附有临证医案参佐。

Uremic pruritus is one of the common complications of uremia in chronic renal failure.Professor Ruan Shiwei systematically summarized the TCM knowledge and clinical treatment experience of uremic pruritus based on the long-term clinical practice experience of TCM and modern related research.He pointed out that the etiology and pathogenesis of uremic pruritus should be based on the basic pathological state of uremia,the internal pathogenic factors of turbid poison,deficiency of blood and body fluid,the inducing factors of six evils in seasons,and the basic pathogenesis is the internal turbid poison,poison outgoing,the deficiency of blood and body fluid,and the loss of nourishment of the skin.According to the characteristics of its pathogenesis,the key points of clinical syndrome differentiation are summarized as"deficiency,heat,toxin and depression",and four therapeutic principles of"tonifying,clearing heat-toxicity,purgative and promoting sweating"are put forward creatively.At the same time,the clinical treatment is based on syndrome differentiation and treatment by stages,and the clinical manifestations of acute stage,chronic stage and chronic relocation delay,as well as the treatment methods,prescriptions and drugs are summarized,with the clinical medical case reference.