从“肺生血”论治肾性贫血

Discussion the Treatment of Renal Anemia from"Lung Generates Blood"

肾性贫血(RA)在慢性肾脏病末期最为常见,且严重妨碍慢性肾脏病患者的病情恢复。其属于中医“血虚”“虚劳”等范畴。近年来有研究表明肺脏具有造血能力,亦可修复骨髓造血功能,即肺可生血。现从气、津、精与血的关系及肺肾阴阳互资角度论述肺生血,并进一步阐述RA病机为:肺气亏虚,无力化生血液;肺阴不足,不可生津及下滋肾精;肾阳不足,无力温煦肺阳。治疗上予以补肺益气生血,滋肺生津、益肾填精,温肾助阳化血,临床上取得较好效果。

Renal anemia(RA)is common at the end of chronic kidney disease and seriously hinders recovery in patients with chronic kidney disease.It belongs to the category of"blood deficiency"and"fatigue"in Traditional Chinese Medicine.In recent years,studies have shown that the lung have hematopoietic ability and can also repair the hematopoietic function of bone marrow,that is,the lungs can generate blood.This paper discusses"lung generates blood"from the perspective of the relationship between qi,fluid,essence and blood and the relationship of Yin and Yang mutual contribution of lungs and kidney,further elaboration of the pathogenesis of renal anemia:deficiency of lung qi and inability to metaplasia blood;insufficient lung yin,which cannot nourish kidney essence;insufficient kidney yang,inability to warm lung yang.In the treatment,it is given to tonify the lungs and promote Qi and blood,nourish the lung and vitality,benefit the kidneys to fill in the essence,warm the kidneys Yang to metaplasia the blood.