基于“肾主气化”理论探讨经方在慢性肾脏病中的临床运用

Exploring the clinical application of classical prescriptions in chronic kidney disease based on the theory of"kidney governing qi transformation"

“肾主气化”的含义涵盖了肾的生理功能,涉及相火敷布、水液代谢、气机升降多个生理环节及肺、脾、胃、三焦、膀胱等多个脏腑,是中医学气化理论的高度概括。文章从“肾主气化”的角度,分析了其与“三焦气化”“膀胱气化”的关系,认为“肾失气化”是慢性肾脏病发生发展的核心病机,指出“肾失气化”与慢性肾脏病病理演变的内在联系。基于“肾主气化”理论,探讨《伤寒杂病论》中经方在慢性肾脏病中的应用,并提出温利结合,疏利三焦法以恢复“肾主气化”功能是改善慢性肾脏病的有效策略。

The meaning of"Kidney governing qi transformation"covers the physiological functions of the kidney,which involves the distribution of phase fire,water-liquid metabolism,the rise and fall of qi and many organs of the lung,spleen,stomach,sanjiao and bladder.It is a high summary of the theory of functional activity of qi of Chinese medicine.In this paper,we analyze the relationship between the kidney,the sanjiao and the bladder from the perspective of the kidney governing qi transformation.We believe that"loss of qi transformation in the kidney"is the core pathogenesis of chronic kidney disease,and point out the intrinsic connection between"loss of qi transformation in the kidney"and the pathological derivation of chronic kidney disease.Based on the theory of"kidney governing qi transformation",we discussed the application of classical prescriptions in the treatise on typhoid miscellaneous diseases in chronic kidney disease,and proposed that combining warmth and purgation and draining the sanjiao to restore the function of"kidney governing qi transformation"is an effective strategy to improve chronic kidney disease.