药物性肾损伤因“毒”致衰的病机

The pathogenesis of drug-induced renal injury caused by toxicity

药物性肾损伤属于中医学“淋证”、“腰痛”、“癃闭”等范畴,发病主要与脾肾二脏功能失调有关。毒与药往往被认为是一体的,毒药因为自身的毒性、炮制、配伍、剂量、煎服、辨证不当可以加重患者的病情,变生他疾或者直接损伤脏腑,从而导致气、血、津、液亏损。当毒药进入机体,则会助邪伤正,耗伤正气,最终形成邪盛正衰的局面。南方医科大学中西医结合医院聂晓莉教授从事医、教、研工作多年,对药物性肾损伤有丰富的临床经验及理论研究,并总结药物性肾损伤病机为“因毒致衰”,治疗上重视健脾补肾、通络泄浊,自拟清毒抗衰方,已在临床上取得一定疗效。

Drug-induced renal injury belongs to the category of“Stranguria syndrome”,“Lumbago”,“Long Bi”in traditional Chinese medicine,related to the dysfunction of spleen and kidney.Poison and medicine are often considered to be one and the same.Because of its own toxicity,preparation,compatibility,dosage,decoction and improper syndrome differentiation,poison can aggravate the patient’s condition,cause other diseases or directly damage the viscera,thus leading to the loss of Qi,blood and body fluid.When the poison invades the body,it will help the evil harm the good,consume the good,and finally form the situation where the evil flourishes and declines.The professor Nie Xiao-Li is the director of the Integrated Hospital of Traditional Chinese Medicine,Southern Medical University,who has been engaged in medical,teaching and research for many years.She has rich clinical experience and theoretical research on druginduced renal injury,the pathogenesis of drug-induced kidney injury is“Decrepitude due to toxin”.The treatment attaches great importance to invigorating spleen and kidney,dredging collaterals and removing turbid,self-designed Qingdu Kangshuai Formula,which has been clinically effective.