马晓燕教授治疗慢性肾脏病经验

Professor MA Xiaoyan's Experience in Treating Chronic Kidney Disease

慢性肾脏病是指肾脏结构、功能异常及(或)肾小球滤过率下降持续>3个月为主要特征的一种临床综合征。该病的发病因素复杂多样,一旦发生若不及时干预则会发展为肾衰竭,严重威胁患者生命及生存质量,给患者家庭及社会带来沉重的经济负担。目前,临床上对该病的治疗主要以控制血压、血糖等对症治疗为主,效果欠佳。马晓燕教授认为该病病机总属肺脾肾亏虚,三焦气化不利,水湿泛滥阻滞气机,致使痰、湿、瘀三邪内生为毒,瘀滞于肾络终成难愈顽疾,强调肾虚为疾病的本质,久病致郁肝失疏泄不可忽视,重视气机升降理论、散结药物、从“毒”及“肾络”论治、灵活用药兼顾虚实阴阳在本病中的应用,阐述了治未病理念及日常调护对该病的重要性。该文是作者通过长期跟师学习,对马晓燕教授治疗慢性肾脏病临床经验的归纳和总结,希望能为该病的临床治疗提供参考。

Chronic kidney disease(CKD)is a clinical syndrome characterized by abnormal renal structure and function and/or decreased glomerular filtration rate for more than 3 months.The pathogenesis of this disease is complex and diverse.Once it occurs,if not timely intervention,it will develop into kidney failure,which seriously threatens the life and quality of life of patients,and brings heavy economic burden to the families and society of patients.At present,clinical treatment of this disease mainly to control blood pressure,blood sugar and other symptomatic treatment,the effect is poor.Professor MA Xiaoyan believed that the pathogenesis of this disease was the three deficiency of lung,spleen and kidney,the three coke was not conducive to vaporization,and the flood of water and dampness blocked the Qi machinery,resulting in the endogenous toxicity of phlegm,dampness and blood stasis in the kidney collateral and eventually became intractable disease.He emphasized that kidney deficiency was the essence of the disease,and the loss and relief of liver caused by chronic illness should not be ignored.It emphasized the application of the theory of lifting of Qi machine,dispersing drugs,treating the disease from“poison”and“kidney collateral”,flexible drug use and combining Yin and Yang in this disease.It expounded the importance of treating nonpathological thoughts and daily nursing for this disease.This article is a summary and summary of Professor MA Xiaoyan's clinical experience in the treatment of chronic kidney disease through long-term study with teachers,hoping to provide reference for the clinical treatment of the disease.