张胜容治疗慢性肾脏病的临证经验

ZHANG Shengrong's Experience on Treating Chronic Kidney Disease

张胜容教授认为“肾衰一病,脾胃先伤”,在慢性肾脏病发生发展过程中,脾肾两脏相互影响,逐渐走向衰败,并伴有湿、浊、瘀、毒等邪实混杂,贯穿全程。张胜容教授根据自身临证经验,将慢性肾脏病分为4种证型,分别为脾肾气虚湿浊内蕴证、湿热内蕴瘀血内阻证、肝肾阴虚浊毒内蕴证及气阴两虚浊瘀互阻证。治疗上主张早期就应顾护脾胃,并根据慢性肾脏病不同时期不同的证型特点,辨证选方用药,并根据标本缓急,急当治其标,以祛邪为主,当病情稳定时,则按其正虚邪实之轻重标本兼治。文章总结张胜容教授临床治疗慢性肾脏病的多年经验,为临床选方用药提供思路。

Professor ZHANG Shengrong believes that“kidney failure causes spleen and stomach injury firstly”.In the occurrence and development of chronic kidney disease,the spleen and kidney interact each other and gradually become decline,accompanied by a mixture of dampness,turbidity,blood stasis,toxin and other substances throughout the whole process.Professor ZHANG classified chronic kidney disease into four syndromes:spleen-kidney Qi deficiency and dampness-turbidity accumulating internally syndrome,damp-heat brewing accumulating internally and blood stasis syndrome,liver-kidney Yin deficiency and intrinsic turbid-toxin syndrome,and Qi and Yin deficiency and turbidity-blood stasis syndrome.In terms of treatment,it is suggested that the spleen and stomach should be taken care of in the early stage.According to different syndromes and characteristics of chronic kidney disease in different stages,prescriptions should be selected according to syndrome differentiation,and the treatment plan should be according to the severity of the disease.In case of critical condition,the treatment should mainly remove pathogenic factors,and when the condition is stable,the treatment should be based on both the symptoms and the root causes of the disease.This article summarized professor ZHANG Shengrong's experience in the clinical treatment of chronic kidney disease for many years,providing ideas for clinical medicine using.