中药药对在慢性肾脏病治疗中的研究进展

A review on TCM couplet medicinals in the treatment of chronic kidney disease

慢性肾脏病(Chronic Kidney Disease,CKD)是由各种肾脏疾病发展而来的一组复杂的临床综合征。其病症复杂,并发症多。目前,西医治疗上有局限性,中医药在CKD的防治方面具有独特的优势。中医认为CKD的基本病机为正虚邪实。早期以脾肾气阴两虚为主,日久脾肾失司,水湿不化,导致湿浊阻滞、瘀血内停和浊毒内生,治疗以扶正补虚和利湿泻浊、化瘀通络并重,从而达到阴阳平衡,改善肾功能,延缓CKD进展的作用。CKD的主要治疗方法是运用中药复方。中药药对是中药复方的核心,它具有简单易用的优点,将中药的传统作用与现代药理作用相结合,使中药药对在治疗CKD中变得灵活精准,同时增加了病症的治疗范围和临床疗效。文章总结了近10年中医药在CKD治疗方面的常用药对,针对不同的中医证候采用不同药对治疗,按不同功效列举了益气养血类(黄芪-当归、黄芪-党参)、补益脾肾类(山茱萸-山药、金樱子-芡实、墨旱莲-女贞子)、活血通络类(蒲黄-五灵脂、三棱-莪术)、利水消肿类(茯苓-猪苓、防己-黄芪)等常用药对在治疗CKD中的临床应用及应用场景,分析中药药对的配伍特色,总结中药药对的传统功效及现代药理研究,为中药药对治疗CKD不同证型的应用提供参考。

Chronic kidney disease(CKD)is a complex set of clinical syndromes that develop from various kidney diseases.Its symptoms are complex and there are many complications.At present,Western medicine has limitations in treatment,and TCM has unique advantages in the prevention and treatment of CKD.TCM believes that the basic pathogenesis of CKD is asthenia healthy Qi(气)and sthenia pathogenic factor.In the early stage,it mainly manifests as the spleen and kidney Qi and Yin(阴)deficiency,and the spleen and kidney dys function for a long time,and the water and dampness abnormal transformed,resulting in turbidity blockade,internal cessation of blood stasis and endogenous turbidity.The treatment should focus on invigorating and replenishing,relieving dampness and removing turbidity and blood stasis,thus achieving the balance of Yin and Yang(阳),improving renal function and delaying the progression of CKD.The main treatment for CKD is the use of TCM compounds.TCM couplet medicinals are the core of TCM compound,which have the advantages of being simple and easy to use,combining the traditional role of TCM medicine with the modern pharmacological effect,making TCM couplet medicinals flexible and accurate in the treatment of CKD,and at the same time increasing the therapeutic scope and clinical efficacy of the disease.This article summarizes the commonly used TCM couplet medicinals in the treatment of CKD in the past 10 years,adopts different TCM couplet medicinals for different TCM symptoms,and gives examples of common TCM couplet medicinals such as those for nourishing Qi and blood[Huangqi(Radix Astragali)-Danggui(Radix Angelicae Sinensis),Huangqi-Dangshen(Radix Codonopsis)],tonifying the spleen and kidneys[Shanzhuyu(Fructus Corni)-Shanyao(Rhizoma Dioscoreae),Jinyingzi(Fructus Rosae Laevigatae)-Qianshi(Semen Euryales),Mohanlian(Herba Ecliptae)-Nvzhenzi(Fructus Ligustri Lucidi)],activating blood circulation[Puhuang(Pollen Typnae)-Wulingzhi(Faecas Trogopterori),Sanleng(Rhizoma Sparganii)-Ezhu(Rhizoma Curcumae)],water relieving and swelling reduction[Fuling(Poria)-Zhuling(Polyporus),Fangji(Radix Stephaniae Tetrandrae)-Huangqi]and other TCM couplet medicinals in the treatment of CKD.This paper analyzes the characteristics of compatibility of TCM couplet medicinals,summarizes the traditional efficacy and modern pharmacological research of TCM couplet medicinals,and provides reference for the application of TCM couplet medicinals in the treatment of different types of CKD.