首页|基于"浊毒蓄损,肾失气化"探讨大黄在慢性肾衰竭中的应用

基于"浊毒蓄损,肾失气化"探讨大黄在慢性肾衰竭中的应用

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慢性肾衰竭属于本虚标实之证,病程较长,脾肾本气早已虚损,迟迟不复,无力气化,肾主气化不及,气血津液代谢不畅,聚而为湿浊、痰热、瘀毒等有形实邪,多种致病产物难于运化排出,久之蕴酿浊毒,浊毒蓄损于官窍,肾主气化不利.浊毒壅滞三焦气机,上下通达失常,肾元衰惫,肾失气化,影响多脏腑功能.结合诸多医家经验,认为浊毒蓄损、肾失气化是慢性肾衰竭的病机特点,发现大黄组方常用于对慢性肾衰竭的治疗且反馈较佳,治疗采用活血消癥、通利气化、去宛陈莝,常用大黄䗪虫丸、桃核承气汤等加减;升降相因、调节气化、泄浊解毒,常用升降散加减;燮理阴阳、温肾化气、推陈致新,常用大黄附子汤、温脾汤加减.大黄扫荡肠腑,给实邪予排出途径,推陈致新,非单通下燥屎,亦泄其寒热浊气、癥积陈腐,从而安和五脏,通调气机,正其阴阳,浊毒得去则气化而能出.
Exploration on the clinical application of rhubarb in chronic renal failure based on the theory of"turbid toxin accumulation-damage,loss of qi transformation in the kidney"
Chronic renal failure belongs to the syndrome of the deficiency of the body and the excess of manifestations with a longer course of disease.Under the condition of spleen-kidney deficiency,the abnormal gasification of qi,poor metabolism of blood and body fluid results in the accumulation of the tangible solid pathogens such as damp pathogen,phlegm-heat and stasis toxin,because of asthenia renal qi.Pathological products cannot be excreted for a long time which is responsible for turbid toxin accumulation-damage and turbid poison accumulates in the official orifices,and the kidney dominates the gasification.Turbid poison stagnates the triple energizer qi machine,leads to abnormal up and down access,exhaustion of kidney yuan,and loss of gasification of kidney,affecting the function of multiple viscera.Based on experience of many physicians,"turbid toxin accumulation-damage,loss of qi transformation in the kidney"are considered as the pathogenesis of chronic renal failure.Furthermore,rhubarb is used frequently in the treatment of chronic renal failure and the curative effect is remarkable.In terms of activating blood circulation for eliminating zheng,promoting diuresis and gasification,and removing wanchenxi,we usually used Dahuang Zhechong Pills,Taohe Chengqi Decoction,etc.in the treatment.In terms of up and down phase cause,adjusting the qi movement,relieving turbidity and detoxification,we usually use Shengjiang Powder in the treatment.In terms of coordinating yin and yang,warming kidney and transforming qi,weeding out the old to bring forth the new,we usually use Dahuang Fuzi Decoction,Wenpi Decoction,etc.in the treatment.Rhubarb dredges fu-organs,gives the solid evil the discharge way,pushes the old to bring forth the new,not only passes the dry excrement,but also discharges its cold,heat,turbid qi,and stale symptoms,so as to calm the five internal organs,regulate the qi,correct its yin and yang,and remove the turbid poison,which can be vaporized and released.

rhubarbturbid toxin accumulation-damageloss of qi transformation in the kidneychronic renal failure

郭杏林、祝昌昊、王钰涵、杨思齐、王耀光

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天津中医药大学第一附属医院,天津 300381

国家中医针灸临床医学研究中心,天津 300381

大黄 浊毒蓄损 肾失气化 慢性肾衰竭

2024

天津中医药
天津市中医药大学,天津中西医结合学会,天津中医药学会

天津中医药

CSTPCD
影响因子:0.998
ISSN:1672-1519
年,卷(期):2024.41(8)