慢性肾病伴发病症的辨析与治疗

The differentiation and treatment of chronic kidney disease with complications

慢性肾病是以蛋白尿、血尿、水肿、高血压等为临床特征的慢性疾病,其病理复杂。若未能及时有效救治,导致病情恶化,则随着病程迁延将发展成为慢性肾功能不全、肾衰竭,最终形成尿毒症。由于其病程漫长,极易出现多病并存的情况,如并发慢性皮肤病、慢性腹泻等。慢性肾病的病变脏腑虽然主要在肾,但皮肤疾病、脾胃疾病亦可影响肾脏的气化功能,导致慢性肾病临床症状加重。肺主皮毛,又为水之上源,肺肾为母子之脏,皮肤与肾脏相关,有专家根据多年临床经验提出“治肾先治皮疹,治肾必调脾胃”的理念和方法,脾胃为后天之本,肾为胃关,肾气通于胃,胃肠与肾脏相关的理论已得到现代医学中系统性淀粉样变性较易累及肾脏和胃肠道,也可并发炎症性肠道疾病等观点的印证,因此治肾必先治皮疹,治肾必辨腹泻,在临床上具有重大实用价值,并在实践中取得了事半功倍的显著效果。文章通过案例分享“治肾先治皮疹,治肾必调脾胃”的经验,以期为临床拓展思路。

Chronic kidney disease is a kind of chronic diseases characterized by proteinuria,hematuria,edema and hypertension.If the disease is not treated in a timely and effective way,it will develop into chronic renal insufficiency,renal failure and eventually uremia.Due to its long course,it is easy to appear many complication diseases,such as chronic skin diseases,chronic diarrhea and so on.Although the pathological changes of chronic kidney disease are mainly in the kidney,skin diseases,spleen and stomach diseases can also affect the gasification function of the kidney,leading to the aggravation of the clinical symptoms of chronic kidney disease.The lungs mainly react in the skin,which is the source of water,and the lungs and kidneys are the organs of mother and child.According to many years of clinical experience,some experts put forward the concept and method of“In the treatment of kidney disease,skin rash must be treated first,and the spleen and stomach must be recuperated must be adjusted”,and achieved remarkable results with half the effort in practice.In this article,the experience in treating the disease based on the above concept and method is shared with some through case analyses,with a view to expanding the clinical thinking.