从脾肾认识高血压肾损害的发展演变规律

【目的】探讨脾肾在高血压肾损害发展演变中的作用。【方法】分析169例高血压肾损害早、中、晚各期患者证候分布及积分值，探讨各期证候特点及转化规律。【结果】本病早期以肝、脾证候积分值最高，其次为肾，阴虚证候最重，其次为气虚证；中期肝、脾、肾积分值较高，阴虚和气虚均较重；晚期五脏皆有涉及，脾、肾积分值最高，气、血、阴、阳俱虚，气虚最重。【结论】肾元不足为本病发生的启动因素和发展转归的根本；脾虚失运是转化和发展的重要环节。

Knowledge on Development and Evolvement Rule of Hypertensive Renal Injury from Spleen and Kidney Theory

[Objective] To explore the effect of spleen and kidney in the development and evolvement of hypertensive renal injury. [Methods] One hundred and sixty nine cases were divided into early,moderate and advanced stage according to the clinical manifestation,analyzing the syndrome distribution and syndrome integral score of each stage and exploring the character and the transform rule between them. [Results] The syndrome integral score of liver and spleen was the highest during early stage with severely manifested kidney,Yin deficiency secondly,and Qi deficiency thirdly. The syndrome integral score of liver, spleen and kidney was higher with more severely Yin deficiency and Qi deficiency during metaphase. The score of spleen,kidney was the highest during advanced stage and the syndrome of liver,spleen,kidney,heart and lung were all involved. The deficiency of both Qi Blood,Yin and Yang were existed with the most ssevere appearance of Qi deficiency. [Conclusion] Deficiency of kidney essence is the pathogenic factor and the crucial factor for the development and evolvement of hypertensive renal injury. Dysfunction of spleen in transporting,distributing and transforming nutrients is an important factor in its development and evolvement.