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从心肾不交探讨慢性肾脏病心血管并发症防治策略

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目前,慢性肾脏病(CKD)的首位死亡病因是心血管疾病(CVD)。"心肾不交"指心火不能下交于肾,肾水不能上济于心,是心肾二者生理功能失衡的表现,心肾不交理论可解释CKD并发CVD的发生发展规律,是其发病的关键因素。其证型主要包括肾水不足心火亢盛证、肾水不升心火独亢证、肾阳亏虚心阳不振证、肾水泛滥凌心射肺证。治疗心肾不交的关键在于恢复心火肾水上下相交的生理功能,即交通心肾,因此运用交通心肾法,心肾同治,通补皆施,标本兼顾,有助于防治CKD并发CVD。
Prevention and Treatment Strategy of Cardiovascular Complications of Chronic Kidney Disease from Heart-Kidney Discordance
Currently,the leading cause of death from chronic kidney disease(CKD)is cardiovascular disease(CVD)."Heart-kidney discordance"means that the heart fire cannot be transferred down to the kidney,and the kidney water cannot be transferred up to the heart,which is the manifestation of the imbalance of physiological functions of the heart and kidney.The theory of heart-kidney discordance can explain the occurrence and development law of CKD complicated with CVD,and is the key factor of its pathogenesis.The main syndrome types include the syndrome of insufficient kidney water and hyperactivity of heart fire,the syndrome of kidney water not rising and hyperactivity of heart fire,the syndrome of kidney yang deficiency and deficiency of heart-yang,and the syndrome of kidney water flooding the heart and shooting the lung.The key to the treatment of heart-kidney discordance is to restore the physiological function of the intersection of heart fire and kidney water,that is,to coordinate the heart and kidney.Therefore,applying the method of coordinating the heart and kidney,treating the heart and kidney simultaneously,administering both tonifying and purging,and targetting both the root causes and symptoms can help prevent and treat CKD complicated with CVD.

chronic kidney diseasecardiovascular diseaseheart-kidney coordinationheart-kidney discor-dancecoordinating the heart and kidney

王睿旖、陈明、吴少波

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成都中医药大学附属医院肾病一科,四川 成都 610072

慢性肾脏病 心血管疾病 心肾相交 心肾不交 交通心肾

国家自然科学基金四川省科技厅重点研发项目

819736732021YFS0034

2024

山东中医杂志
山东中医药学会 山东中医药大学

山东中医杂志

CSTPCD
影响因子:0.431
ISSN:0257-358X
年,卷(期):2024.43(1)
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