基于“阴火学说”益气升阳散火法治疗慢性肾衰竭的探索

Treatment of chronic renal failure by supplementing qi,promoting yang and dispersing fire based on“yin-fire theory”

慢性肾脏病(CKD)患病率持续上升,CKD发展为慢性肾衰竭(CRF)将对公众健康及社会经济产生巨大影响,目前对CRF尚缺乏有效的治疗方法。“阴火学说”是李东垣的核心学术思想之一,“阴火”的病机在于元气不足,气火关系失调,而以“脾胃受损、阴火内盛”为其核心。在“阴火”的治疗上,以“补中气、升清阳、泻阴火”为主要治法。CRF脾肾气虚兼内热证与“阴火学说”的病机特点高度相似。本文以“阴火学说”为基础,应用益气升阳散火法为主治疗CRF脾肾气虚兼内热证患者,并进行了回顾性分析,初步显示出益气升阳散火法治疗CRF的良好疗效和安全性。

The prevalence of chronic kidney disease(CKD)continues to rise.The development of CKD into chronic renal failure(CRF)will impose a huge burden on public health and social economy.So far,there is no effective treatment for CRF.“Yin-fire theory”is one of the core academic thoughts of Li Dongyuan.The pathogenesis of“yin-fire”lies in the insufficiency of vital energy and maladjustment of relationship between qi and fire.The core is“damaged spleen-stomach,excessive yin-fire”.In the treatment of“yin-fire”,the main method is“invigorating the middle qi,promoting yang and reducing yin-fire”.The pathogenesis of CRF characterized by qi deficiency of spleen and kidney and internal heat is highly similar to that of“yin-fire theory”.Based on the“yin-fire theory”,the author used the method of invigorating qi,promoting yang and dispersing fire to treat CRF patients with spleen-kidney qi deficiency and internal heat syndrome,and made a retrospective analysis accordingly.The preliminary results showed that the method of supplementing qi,promoting yang and dispersing fire was effective and safe in the treatment of CRF.