从中医体质学说理论探析慢性肾脏病的防治

An analysis of the prevention and treatment of chronic kidney disease from the constitution theory of TCM

慢性肾脏病因其发病率高、并发心血管病率高、致残率高、医疗费高已成为困扰全球性公共卫生健康问题。延缓慢性肾脏病进展的关键是及早发现及早干预,早期防治才能改善本病的预后。体质状态反映正气强弱,决定发病与否,也影响发病倾向,个体体质的差异性导致对某些致病因子有着易感性,或对某些疾病有着易罹性,形成某些(类)疾病发生的背景或基础,还是预测疾病发展、转归、预后的重要依据。体质具有相对稳定和动态可调的特征,“体病相关论”在慢性病防控研究中逐渐被深入应用。文章从中医体质学入手,阐述了体质与疾病的相关性,总结慢性肾脏病中医体质分布特点,发现体质与慢性肾脏病发病具有相关性,气虚质对慢性肾脏病有易罹性,且在慢性肾脏病患者中,虚性体质以气虚质、阳虚质、阴虚质为多,实性体质以痰湿质、血瘀质、湿热质为多。文章试论中医体质角度下的慢性肾脏病病因病机,探讨运用中医体质学说指导慢性肾脏病的防治,主要从辨体养生层面未病先防、从体质影响因素层面预防与调摄慢性肾脏病、从主要体质类型层面预防与调摄慢性肾脏病、从辨体-辨病-辨证体系层面防治慢性肾脏病等四个层面论述。文章最后讨论了目前中医体质学说在慢性肾脏病临床运用方面的不足,并对今后的研究方向提出期待和展望。

Chronic kidney disease has become a global public health problem due to its high incidence,high rate of cardiovascular disease,high disability rate and high medical costs.The key to delaying the progression of chronic kidney disease is early detection and early intervention,and early prevention and treatment can improve the prognosis of the disease.TheC difference of individual physique leads to susceptibility to certain pathogenic factors,or susceptibility to certain diseases,forming the background or basis for the occurrence of certain(class)diseases,and is also an important basis for predicting the development,prognosis and prognosis of diseases.The constitution has the characteristics of relative stability and dynamic adjustment,and the body disease correlation theory has been gradually applied in the research of chronic disease prevention and control.Starting from the physique of TCM,this paper expounds the correlation between constitution and disease,summarizes the distribution characteristics of TCM constitution in chronic kidney disease,and finds that constitution is correlated with the onset of chronic kidney disease,Qi(气)deficiency is susceptible to chronic kidney disease,and in chronic kidney disease patients,the deficiency constitution is mostly Qi deficiency,Yang(阳)deficiency and Yin(阴)deficiency,and the solid constitution is mostly phlegm dampness,blood stasis and damp heat.This paper also discusses the etiology and pathogenesis of chronic kidney disease from the perspective of TCM constitution,and discusses the use of TCM constitution theory to guide the prevention and treatment of chronic kidney disease,mainly from the four levels of prevention of chronic kidney disease at the level of body differentiation and health preservation,prevention and regulation of chronic kidney disease from the level of physical influencing factors,prevention and regulation of chronic kidney disease from the level of major constitution types,and prevention and treatment of chronic kidney disease from the level of body differentiation-disease differentiation-syndrome differentiation system.Finally,the shortcomings of the current TCM constitution theory in the clinical application of chronic kidney disease are discussed,and the future research directions are put forward.