基于肠-肾轴理论谈国医大师王世民“通下法”治疗慢性肾脏病经验

Professor Wang Shimin′s Experience in the Treatment of Chronic Kidney Disease by Relaxing Bowels Based on the Theory of Gut-Kidney Axis

王世民教授是山西省著名的名老中医,从医60余年,在中医药临床和基础研究多年,尤其倾心研究中药及中医方剂,数十年来科研成果显著,他倡导“仰古尚新、与时俱进、中西兼容、它山之石可以攻玉”的理念,强调“医应识药”,探幽发微,融汇古今。基于西医肠-肾轴理论从中医谈王世民教授临床中医药治疗疾病的经验,慢性肾脏病属本虚标实,其基本病机主要为虚、瘀、湿、浊,临床主要治则为“补肾活血,降浊排毒”,且强调“通下法”在治疗过程中的重要性,以泻下药物为主组方,用通利大便的方法去除浊毒,以祛菀陈莝达到治疗疾病的目的。王世民教授基于肠-肾轴认为肠道菌群失调也可看作人体阴阳失衡的一部分,中药及复方可通过调节肠道菌群改善机体阴阳平和而治疗疾病,提出“从肠治肾”,在临床疗效显著。为探讨中医药治疗慢性肾脏病的作用机制提供新思路,为临床治疗慢性肾脏病提供一个新方向。

Professor Wang Shimin, a prestigious veteran doctor of traditional Chinese medicine(TCM)in Shanxi Province, has been engaged in medical work for more than 60 years, especially TCM clinical practice and basic research.He has devoted himself to the research on Chinese herbal drugs and TCM prescriptions, with remarkable scientific achievements for decades.He advocates the concepts of“inheritance and innovation, advance with the times, integration of TCM and western medicine, and the stones from other hills serving to polish the jade” and emphasizes that “doctors should identify TCM drugs”.Besides, he highlights broadening the horizon and integrating the ancient and modern quintessence.Based on the gut-kidney axis theory of western medicine, this study discussed Professor Wang Shimin′s experience in treating diseases with TCM.Chronic kidney disease is characterized by asthenia in origin and sthenia in superficiality, and its basic pathogenesis is attributed to deficiency, stasis, dampness, and turbidity.The clinical treatment mainly follows the principles of tonifying the kidney, activating the blood, reducing turbidity, and removing toxins.The importance of “relaxing bowels” is highlighted in the treatment.The turbid toxin was removed by relaxing bowels with prescriptions mainly consisting of purgative drugs, thereby achieving the purpose of the treatment of disease by defecation.Based on the gut-kidney axis, Professor Wang believes that intestinal flora alteration can also be regarded as a part of the imbalance of yin and yang in the human body, and TCM drugs and compounds can treat diseases by regulating intestinal flora to improve the balance of yin and yang in the body, and proposes the treatment of the kidney from intestines, with remarkable clinical efficacy.This study is expected to provide a new idea and a new direction to explore the mechanism of TCM treatment and clinical treatment of chronic kidney disease.