国医大师李振华从虚、浊、瘀、毒、衰论治慢性肾功能衰竭经验介绍

Experience of Chinese Medicine Master LI Zhenhua in Treating Chronic Renal Failure from Deficiency,Turbid,Stasis,Toxin and Debilitation

国医大师李振华教授认为,慢性肾功能衰竭的基本病机为虚、浊、瘀、毒、衰五个方面,虚证以脾肾气(阳)虚和肝肾阴虚为主;浊是由于脾肾阳虚痰饮、水湿内停,湿浊内蕴;瘀是因虚致瘀,瘀阻肾络,贯穿疾病始终;毒是指痰浊、瘀血等病理产物,在体内停滞日久,胶着不去,在肾形成微型癥积,浊毒内聚,毒损肾络,出现浊毒证;衰是湿浊羁留,肾功能衰败。该病为本虚标实之证,而以肾气衰败为本,湿浊血瘀、瘀毒为标,即虚、浊、瘀、毒、衰相互夹杂为其病机。治疗原则以补脾肾为本,以祛湿降浊、活血祛瘀、解毒排毒为标,由于慢性肾功能衰竭的病机复杂,临证要紧抓病机,结合整体与局部,内外兼治,才能收到良好效果。

Prof. LI Zhenhua, a Chinese medicine master, believes that the basic pathogenesis of chronic renal failure includes five aspects, which are deficiency, turbid, stasis, toxin and debilitation.Deficiency is mainly spleen-kidney yang deficiency and liver-kidney yin deficiency;turbid is caused by spleen-kidney yang deficiency,internal retention of phlegm rheum and water-dampness,and retained dampness turbid in the body;stasis, which is due to deficiency and obstructs kidney collaterals, runs through the whole course of the disease;toxin is due to pathological products,such as phlegm turbid and blood stasis, stagnating in and sticking to the body for a long time, micro accumulation of concretions being formed,turbid toxin being accumulated in the body,kidney collaterals being damaged by toxin,and turbid toxin syndrome being caused;debilitation is due to the intention of dampness turbid and kidney function failure. The disease is a syndrome of deficiency in the origin and excess in the superficiality,the decline of kidney qi being the root cause and dampness turbid, blood stasis and stasis toxin being the symptom. The complex of deficiency, turbid, stasis, toxin and debilitation is the pathogenesis of the disease. Supplementing the spleen and kidney should be the root cause of the treating principle, and dispelling dampness and directing the turbid downward, invigorating blood and dispelling stasis, and detoxifying and eliminating toxin as the symptom. Because of the complicated pathogenesis of chronic renal failure, we should pay attention to the pathogenesis, combine the whole and the part, treat both the interior and the exterior,and great effects can be achieved.