张大宁从虚、瘀、湿、逆论治慢性肾功能衰竭经验

张大宁认为,慢性肾功能衰竭的基本病机为虚、瘀、湿、逆四个方面,虚证有脾肾气(阳)虚和肝肾阴虚两种;湿证有湿困、水湿之不同,共同造成湿浊内蕴;逆证主要为浊毒上逆;瘀证则贯穿于疾病始终。该病为本虚标实之证,而以肾气衰败、肾虚血瘀为本,湿浊内阻、浊毒犯逆为标,即虚、瘀、湿、逆相互夹杂为其病机。总体治疗原则为补肾活血以治本、祛湿降逆以治标,临证做到整体局部相结合、理证治病相结合、多种治法相结合。

Experience of ZHANG Daning Treating Chronic Renal Failure Based on Deficiency,Stasis,Dampness and Adverse

ZHANG Daning believes that the pathogenesis of chronic renal failure can be summed up in 4 aspects: deficiency,stasis,dampness and adverse . Deficiency syndrome includes deficiency of spleen and kidney qi ( yang) and deficiency of liver and kidney yin;Dampness syndrome had dampness stagnancy and water dampness,causing internal retention of dampness and turbidity. Adverse syndrome is mainly adverse rising of turbidity toxin. Stasis syndrome is running through the whole course of diseases. This diseases is syndrome of root deficiency and manifestation excessive,with the root of kidney qi failure,kidney deficiency and blood stasis,and with the manifestations of internal obstruction of dampness turbidity,adverse flow of turbidity toxin,which means its pathogenesis is intermingled deficiency,stasis,dampness and adverse. The overall treatment principles should be invigorating the kidney and activating blood circulation to treat the root causes,and dispersing dampness and descending adverse qi to treat the manifestations. Clinical treatment should combine with whole and local,syndrome differentiation and disease treatment,and multiple treatment methods.