基于肾络理论浅析慢性肾脏病的辨证施治

Analysis of syndrome differentiation and treatment of chronic kidney disease based on the theory of kidney collaterals

慢性肾脏病是指肾脏结构、功能障碍超过3个月,可有蛋白尿、血尿、水肿、肾功能减退等诸多表现,属于临床难治性疾病范畴,最终往往进展至终末期肾病。而从中医肾络理论出发,肾络网络分布于肾脏,是肾之气血津液运行输布的重要通道,由于六淫外邪、瘀血、痰饮、浊毒等致病因素侵袭肾络,久病入络,致使络道气机郁滞、血行不畅,脏腑功能紊乱,从而引起尿浊、尿血、水肿、癃闭等诸多病变。“肾络瘀阻”是肾络病发生的核心病机,久之肾络渐损,即可进一步进展为“溺毒”“关格”等肾功能衰竭的病理阶段。基于肾络理论,运用中医药疗法对慢性肾脏病辨证施治,可有效减轻肾络病症,改善肾功能,从而控制疾病进展。

Chronic kidney disease refers to the structure and dysfunction of the kidney for more than three months,which may have many manifestations such as proteinuria,hematuria,edema,and renal dysfunction.It belongs to the category of clinically refractory diseases,and it often progresses to end-stage renal disease.While starting from the theory of kidney collaterals in Chinese medicine,the network of kidney collaterals is distributed in the kidneys and is an essential channel for the circulation and transfusion of the qi,blood,and body fluid of the kidneys.Due to pathogenic factors invade the kidney network,including six external pathogens,blood stasis,phlegm,and turbidity,and the long-term illness enters the collaterals,stagnation of collateral qi,poor blood circulation,and dysfunction of the viscera occurs,resulting in turbid urine,blood in the urine,edema,obliteration and many other diseases."Kidney collateral stasis"is the core pathogenesis of kidney collateral disease.If the kidney collateral is gradually damaged over time,it can further progress to the pathological stage of renal failures,such as"nidu"and"guange".Based on the theory of kidney collaterals,the use of traditional Chinese medicine to treat chronic kidney disease based on syndrome differentiation can effectively reduce kidney collateral disorders,improve kidney function,and control disease progression.