从“水渍三焦”理论探讨腹膜透析并发症病机

Probe into the pathogenesis of peritoneal dialysis complications from the theory of“Water-stained Sanjiao”

“水渍三焦”是基于“腹膜属于三焦范畴”,在中医“取象比类”思维下提出的理论,旨在从中医角度解释腹膜透析并发症的根本病机,为其防治提供思路。水渍三焦理论认为,腹膜透析作为肾替代治疗的一个重要手段,其本身也是一种致病因素,透析液进出腹膜腔的过程,正如“水渍房屋,水退湿存”,水湿之邪侵犯三焦,引起三焦气化、转运水谷等功能发生障碍,进而影响心、肺、脾、肾、胃、肠、膀胱等多重脏腑机能,兼之慢性肾衰竭患者多有脾肾虚损,故种种相关并发症由此产生。此外,提出腹膜微炎症状态或为“水渍三焦”病理实质。

The theory of“Water-stained Sanjiao”,based on the view that the peritoneum belongs to the category of Sanjiao and put forward under the thinking of“image analogy”in traditional Chinese medicine,aims to explain the fundamental pathogenesis of peritoneal dialysis complications from the perspective of traditional Chinese medicine and provide ideas for its prevention and treatment.This theory believes that peritoneal dialysis,as an important means of renal replacement therapy,is itself a pathogenic factor.The process of dialysate in and out of the peritoneal cavity is like water soaks the house and then goes back.Water dampness invades the Sanjiao,causing dysfunctions such as energization and water transfer,which in turn affects the heart,lung,spleen,kidney,stomach,intestines,bladder and other multiple organ functions.Also,patients with chronic renal failure often suffer from spleen and kidney deficiency.Related complications arise from this.In addition,the article proposes that the peritoneal micro-inflammatory state may be the essence of“Water-stained Sanjiao”.