基于“浊毒”理论论治慢性肾脏病

Discussion on the Treatment of Chronic Kidney Disease Based on Turbid and Toxic Theory

浊邪是指具有浑秽、稠厚、黏滞、胶结特性的一类内生病理产物或致病因素,浊邪蕴久化毒,出现浊、毒的双重致病特征时,称为'浊毒'。浊毒致病,有浑秽、重浊、火热、广泛、危重、顽固的特征,符合慢性肾脏病临床表现和病程特点。慢性肾脏病起病隐匿,日久脾肾衰败,无力运化水湿,致浊邪壅滞,恋久化毒。浊邪'毒化',直伤脏腑,变证丛生,多见于慢性肾脏病3~5期,提示病情危重。浊毒与慢性肾脏病的发生、发展和转归等密切相关,治疗上宜用发表透浊、芳香化浊、渗湿利浊、通腑泄浊、辛开苦降等法,因势利导,驱邪以安正。

Turbid evil refers to a kind of endogenous pathological products or pathogenic factors with the characteristics of muddy,thick,viscous and cemented.Turbid evil that stagnates for a long time can transform into the toxic,it is called turbid and toxic when there appears dual features of the turbid and toxic.Turbid and toxic has the characteristics of muddy,heavy and viscous,hot,widespread,severe and obstinate,which agrees the clinical manifestation and course features of chronic kidney disease(CKD).The onset of CKD is hidden,turbid evil stagnates and transforms to toxic after a long term because spleen and kidney deficiency and are unable to transfer water and dampness.After turbid evil transforms into toxic,turbid and toxic can damage zang and Fu organs directly and cause various complications,commonly seen in stage 3-5 of CKD,suggesting a critical condition.Turbid and toxic has a close connection with the onset,development and prognosis of CKD.For treatment,it is suggested to use disperse surface and permeate turbidity method,aromatization of turbidity method,infiltration of turbidity and dampness method,purge the Fu organs and excrete turbidity method,the pungent opening and the bitter downward method to expel evils.