谢圣芳教授辨治慢性肾衰竭并发胃肠功能紊乱经验

Professor Xie Shengfang’s Experience in Treating Chronic Renal FailureComplicatedby Gastrointestinal Dysfunction

胃肠功能紊乱是慢性肾衰竭常见的并发症,临床上表现为恶心、呕吐、腹痛、便秘和腹泻,严重影响患者生活质量,且目前尚无明确的有效治疗措施。谢圣芳教授(以下简称谢师)认为本病病机可归结为本虚标实,以脾肾虚衰、邪实潴留为主要病理状态。治疗上以注重维护肾气、顾护脾胃为原则,遣方用药偏于和缓,攻补兼施,以缓解患者临床症状,提高生活质量和延缓生存期,对慢性肾衰竭并发胃肠功能紊乱患者疗效显著。笔者师从谢圣芳教授,长期跟诊于谢师左右,记录其临床治疗肾脏相关疾病的临证思考与见解,并举医案一则,为中医药治疗慢性肾衰竭并发胃肠功能紊乱提供新的治疗思路。

Gastrointestinal dysfunction is a common complication of chronic renal failure,with clinical manifestations of nausea,vomiting,abdominal pain,constipation,and diarrhea,which seriously affect the quality of life of patients and lack effective treatment measures.Professor Xie Shengfang believes that the pathogenesis of this disease can be attributed to the deficiency of spleen and kidney and the retention of pathogenic substances is the main pathological state.Therefore,the treatment should follow the principle of maintaining kidney qi and protecting spleen and stomach.According to this principle,the mild medicinal materials should be used for both tonification and elimination,so as to relieve the clinical symptoms,improve the quality of life,and prolong the survival period.Such treatment is effective for patients with chronic renal failure complicated with gastrointestinal dysfunction.The author has been learning after Professor Xie for a long time.This paper introduces Professor Xie's clinical thoughts and insights in the clinical treatment of kidney diseases and reports the treatment of one case,aiming to provide a new idea for the treatment of chronic renal failure complicated by gastrointestinal dysfunction with traditional Chinese medicine.