王耀献基于“心肾相关”理论分期辨治Ⅳ型心肾综合征

Wang Yaoxian Treating TypeⅣCardiorenal Syndrome Based on"Heart and Kidney Correlation"Theory

Ⅳ型心肾综合征发病以“心肾相关”为重要生理基础,其内涵主要包括经络互联、水火既济、君相互助、血水共运。本病多属本虚标实证,心肾(气)阳虚为发病之基,标实多并发水饮血瘀,气、血、水相互搏结,交互影响,为Ⅳ型心肾综合征发展及加重之根本。王耀献教授基于“心肾相关”理论,结合气血水病理交互特点,构建气血水并治原则,临床常以益气、温阳、化饮、利水、活血法,分期权衡,杂合施治。早期益气护肾,消癥散结治本;中期益气活血,化瘀利水;后期多温阳化气,利水消肿。临证强调综合治疗,防治结合。

The pathogenesis of typeⅣcardiorenal syndrome is based on the important physiology of"Heart and Kidney correlation",the connotation of which mainly includes meridian interconnection,Water and Fire balance,mutual help of Heart Fire and Kidney Fire as well as blood and Water simultaneous transportation.This disease is mostly deficiency in essence and excess in manifestation.Specifically,the deficiency of Heart and Kidney(Qi)Yang is the basis of the disease,and the excess is often the mixture of Water and blood stasis.Qi,blood and Water fight against and interact with each other,which is the root of the development and aggravation of typeⅣcardiorenal syndrome.Based on the theory of"Heart and Kidney correlation",combined with the pathological interaction characteristics of Qi,blood and Water,Professor Wang Yaoxian constructed the treatment principle of simultaneous regulating of Qi,blood and Water.In clinical practice,it is often treated with the methods of invigorating Qi,warming Yang,dissolving Phlegm,alleviating Water retention,and invigorating blood circulation.Heterozygous treatment by stages is carried out.In the early stage,invigorating Qi and protecting the Kidney,dissipating and dispersing the mass accumulation to deal with the root of the disease;Invigorating Qi and activating blood circulation,dissolving stasis and improving Water metabolism in the middle stage;In the last stage,warming the Yang to encourage Qi to reduce Water stagnation and swelling.In clinical practice,comprehensive treatment as well as combination of prevention and treatment are emphasized.