新型冠状病毒感染导致慢性肾脏病进展的病因病机探讨
Discussion on the etiology and pathogenesis of chronic kidney disease progression caused by COVID-19
王悦 1孙鲁英 2姚志 1尚唱1
作者信息
- 1. 北京中医药大学东直门医院 北京 100700
- 2. 北京中医药大学东直门医院 北京 100700;北京中医药大学房山医院
- 折叠
摘要
慢性肾脏病(CKD)患者是新型冠状病毒(简称"新冠",COVID-19)感染的易感及高危人群,COVID-19 累及肾脏可出现肾功能减退甚至慢性肾脏病基础上急性肾损伤.新冠感染导致CKD进展的关键病因为体虚邪凑、内外合邪,主要病机包括:肾气亏虚为病理基础,肾络瘀结为核心病机,肺肾同损为预后不良原因,气阴两虚为新冠愈后肾功能未恢复原因.临床需分期论治,未病应养正固本、避其邪气,已病需益气化瘀、肺肾同治,瘥后当益气养阴、荡涤余邪.
Abstract
Patients with chronic kidney disease(CKD)are susceptible to and at high risk of coronavirus disease 2019(COVID-19).COVID-19 can cause renal dysfunction and even acute kidney injury in patients with CKD.The key pathogenic factors for the progression of CKD caused by COVID-19 are deficiency of vital energy and invasion of pathogenic factors,both internally and externally.The main pathological mechanisms include:kidney-qi deficiency as the pathological basis,stasis of the kidney collaterals as the core mechanism,lung-kidney impairment as the reason for poor prognosis,and deficiency of both qi and yin as the reason for the failure of kidney function to recover post COVID-19 convalescence.Clinical treatment should be staged according to the disease progression.In the pre-disease stage,efforts should focus on strengthening the body's constitution and avoiding pathogenic influences.In the active disease stage,treatment should aim to tonify qi,resolve blood stasis,and concurrently address lung and kidney issues.In the post-recovery stage,treatment should focus on replenishing qi,nourishing yin,and eliminating any residual evils.
关键词
新型冠状病毒感染/慢性肾脏病/病因病机Key words
COVID-19/chronic kidney disease/etiology and pathogenesis引用本文复制引用
基金项目
国家重点研发计划(2018YFC1704304)
出版年
2024
国家科技期刊平台
NSTL
万方数据