基于“肾脑相济”理论探讨神经源性排尿困难

Neurogenic dysuria based on the Theory of Kidney-Brain Interaction

神经源性排尿困难属于神经源性膀胱(neurogenic bladder,NB)的范畴,是由于神经病变引起的一系列下尿路功能障碍,表现为排尿困难,重者出现尿潴留,伴或不伴急迫性尿失禁。中医学中神经源性排尿困难属于“癃闭”范畴,其病位在膀胱。肾与膀胱互为表里,尿液的排泄需要肾的气化与膀胱的固摄共同配合。随着肾脑理论的不断完善,二者在物质与经络等方面的密切联系在临床中的应用也愈加丰富。文章基于“肾脑相济”理论探讨神经源性排尿困难发病机制及治疗,揭示脑、肾、膀胱之间的联系,为临床上认识及治疗神经源性排尿困难提供新思路。

Neurogenic dysuria belongs to the category of neurogenic bladder(NB),which is a series of lower urinary tract dysfunction caused by neuropathy,manifested by dysuria,and in severe cases urinary retention,with or without urge incontinence.In Chinese medicine,NB belongs to the category of"retention of urine"and its location is in the bladder.Since the kidney and the bladder are mutually exclusive,the excretion of urine requires the joint cooperation of the kidney's qi and the bladder's solidification.Therefore,this paper discusses the pathogenesis and treatment of NB based on the theory of"Kidney-brain interaction",reveals the connection between the brain,kidney and bladder,and provides new ideas for the clinical understanding and treatment of neurogenic dyspareunia.