基于“肾络–玄府”理论探讨慢性肾脏病的论治

Exploration of the Treatment of Chronic Kidney Disease Based on the Theory of “Kidney Connection-Xuanfu”

慢性肾脏病因其病位在肾,根据现代医学对肾脏微观构造的理解,认为肾络–玄府有着管控精微物质输布运行的功能。从肾络–玄府出发,认为慢性肾脏病的主要病机为肾络瘀阻,玄府郁闭,从而导致气血津液代谢输布异常,气机失调,成为疾病发生的基础。慢性肾脏病发展到后期,肾小球滤过屏障遭到破坏、滤过率降低、肾小球萎缩、间质纤维化、肾小球硬化与祖国医学“肾络瘀阻,玄府郁闭”思想相关。因此,文章基于“肾络–玄府”理论,以“辛温行散以启玄府郁闭,搜剔肾络癥瘕以复肾气”立法,探究秦艽丸在慢性肾脏病中的应用,总结出辛味通玄、补益开玄、和营通玄、搜剔通玄、燥湿通玄五种治法,从而为临床治疗慢性肾脏病提供一种可行性的思路与方法。

Chronic Kidney Disease (CKD) is located in the kidney, and according to the understanding of the microstructure of the kidney in modern medicine, it is believed that the kidney meridian-Xuanfu has the function of controlling the transmission and distribution of subtle substances. Starting from the Kidney-Xuanfu, it is believed that the main pathogenesis of chronic kidney disease is the obstruction of the renal veins and the closure of the Xuanfu, which leads to abnormal metabolism and distribution of qi, blood and fluid, and imbalance of qi and organs, which becomes the basis for the occurrence of the disease. In the later stage of chronic kidney disease, the glomerular filtration barrier is destroyed, the filtration rate is reduced, and the glomerular atrophy, interstitial fibrosis, and glomerulosclerosis are related to the idea of “kidney collateral stasis and Xuanfu stasis” in the medicine of the motherland. Therefore, in this paper, based on the theory of “Kidney Circulation-Xuanfu”, the application of Qinjiao Pill in chronic kidney disease was explored by the legislation of “Xinwen Xingsan to open Xuanfu depression and closure, and to search for kidney and blood to restore kidney qi”, and summarized five treatment methods of Xinwei Tongxuan, Tonic Kaixuan, Heying Tongxuan, Souti Tongxuan, and Dry and Damp Tongxuan, so as to provide a feasible idea and method for the clinical treatment of chronic kidney disease.