摘要
慢性肾功能衰竭主要病位在于肾,但在慢性肾炎发展至慢性肾功能衰竭过程中,主要是因为脾肾逐渐亏虚,脾胃功能失调,导致湿热瘀血痰浊阻滞机体,进而成为尿毒症。李东垣以脾胃为核心辨证论治,提出"重中气、升阳气、降阴火"之理论。"重中气"即注重脾胃中气之调理,并提出5个基本方剂,即湿胜者平胃散,气弱自汗者黄芪建中汤,脉虚血弱者四物汤,真气虚弱者四君子汤,小便闭涩者五苓散。"升阳气"即重视阳气的升发,重点方剂如补中益气汤、升阳益胃汤、升阳除湿汤等。"阴火"者,即机体因脾胃虚弱、气血阴阳不足、脏腑功能失调所导致的一种病理机制。"降阴火"即标本同治,既要调和脾胃,又要制约阴火,经典方剂为补中益气汤。慢性肾功能衰竭患者治疗过程中并发症较多,且容易反复发作,从李东垣"重中气、升阳气、降阴火"理论治疗,能有效调理脾肾功能,改善预后,提高患者生活质量。
The main site of chronic renal failure lies in the kidney. However,during the development of chronic nephritis to chronic renal failure,the Spleen and Kidney are gradually deficient,and the Spleen and Stomach are dysfunctional,which causes diseases related to the Dampness,Hotness,Blood stagnation and Turbid. Li Dongyuan took the Spleen and Stomach as the core of diagnosis and treatment,and put forward the theory of "emphasizing Zhong Qi,tonifying Yang Qi,and lowering Yin Fire". "Emphasizing Zhong Qi" refers to the conditioning of the Spleen and Stomach,and 5 basic prescriptions were proposed,namely,Pingwei Powder for Dampness Syndrome,Huangqi Jianzhong Decoction for Qi dificiency and sweaty,Shiwu Decoction for weak in pulse and Blood,Si Junzi Decoction for weak in Zhen Qi,Wuling Powder for closed urine. "Tonifying Yang Qi" means to encourage the rise of Yang Qi,and the key prescriptions are Buzhong Yiqi Decoction,Shengyang Yiwei Decoction and Shengyang Chushi Decoction. "Yin fire" is a pathological mechanism caused by the weakness of the Spleen and Stomach,with insufficient Blood,Yin and Yang,as well as visceral dysfunction. "Reducing Yin fire" means to treat the symptoms and root causes simultaneously. It is necessary to reconcile the Spleen and Stomach as well as restricting the Yin fire,by using Buzhong YIqi Decoction. Patients with chronic renal failure have more complications during treatment and are prone to be faced with recurrent attacks. From Li Dongyuan’ s theory,Spleen and Kidney function can be effectively regulated,as well as improving prognosis and improving patients’ quality of life.
作者
夏娟娟
谭颖颖
黄笛
许生
XIA Juanjuan;TAN Yingying;HUANG Di;XU Sheng(Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712046)
出处
《中医学报》
CAS
2020年第2期266-269,共4页
Acta Chinese Medicine
基金
陕西省教育厅专项科学研究计划项目(16JK1209)
陕西省自然科学基础研究计划项目(2016JM-8049)
陕西省中医管理局中医药科研课题项目(15-JC002)。
关键词
慢性肾功能衰竭
李东垣
重中气
升阳气
降阴火
chronic renal failure
Li Dongyuan
emphasizing Zhong Qi
tonifying Yang Qi
Lowering Yin Fire
