基于方药中辨证论治五步法之“必先五胜”辨治慢性肾衰竭

Treatment of Chronic Renal Failure Based on FANG Yaozhong’s“Bixian Wusheng”Five-step Method of Syndrome Differentiation and Treatment

“必先五胜”是方药中教授创立的辨证论治五步法中最关键一步,具有承辨证启论治的作用。应用“必先五胜”辨治慢性肾衰竭,一方面,可承上以审清病机之本,明确原发与继发,辨病位之本;明确真假异同,辨病性之本;审度病情轻重缓急,辨病势之本。另一方面,启下以确立扶正补虚为主、兼以祛邪的治疗原则,并创立治疗慢性肾衰竭的脾、肾系列方药。应用此法辨治慢性肾衰竭经临床观察疗效佳,以此法制定的慢性肾衰竭的证治体系被中国中医科学院西苑医院肾病科及其传承人广泛应用。

“Bixian Wusheng”is the most critical step in the five-step method of syndrome differentiation and treatment established by professor FANG Yaozhong,which has the effect of guiding syndrome differen⁃tiation,starting and facilitating effective treatment.Applying"Bixian Wusheng"into the differentiation and treatment of chronic renal failure,on the one hand,it serves to examine the pathogenesis,distinguish primary from secondary factors,and identify the positioning of the disease,differentiate between authentic symptoms versus misleading ones as well as assessing disease severity,and identify the development of the disease.On the other hand,its starting and facilitating effective treatment means introducing principles of strengthening healthy qi,tonifying diffiency while expelling patho⁃genic factors,and establishing a range of spleenkidney prescriptions tailored for addressing chronic renal failure.Clinical studies have demonstrated that employing this method yields positive outcomes in the differentiation and treatment of chronic renal failure.Consequently,the Nephrology Department of Xiyuan Hospital,China Academy of Chinese Medical Sciences,widely adopts this syndromic approach to treat chronic renal failure.