文献类型：期刊文献

中文题名：基于《黄帝内经》“正本清源”理论分析刘宝厚教授治疗慢性肾脏病的临床经验

英文题名：Professor LIU Baohou's experience in treating chronic kidney disease based on the theory of“returning to the root and clarifying the source”in Huangdi Neijing

作者：李永荣[1];何晨曦[2];赵雪红[3];薛国忠[1]

第一作者：李永荣

机构：[1]甘肃中医药大学附属医院,甘肃兰州730030;[2]秦安县人民医院,甘肃天水741600;[3]甘肃中医药大学,甘肃兰州730030

第一机构：甘肃中医药大学第二附属医院

年份：2025

卷号：17

期号：35

起止页码：136

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：甘肃省中医药科研项目(GZKP-2022-17)。

语种：中文

中文关键词：慢性肾脏病;脾肾两虚;临床经验

外文关键词：Chronic kidney disease;Spleen-kidney deficiency;Clinical experience

摘要：慢性肾脏病是以肾脏结构/功能障碍≥3个月为特征的常见泌尿系统疾病,全球患病率约13%。该病临床表现为水肿、高血压、蛋白尿等,易进展至终末期肾病,需依赖透析或肾移植维持生命。刘宝厚教授基于《黄帝内经》“正本清源”理论,提出“标本兼治,祛邪安正;瘀血不去,肾气难复;湿热不除,蛋白难消”的核心思想,构建以肾气亏虚为“本”、瘀血湿热为“标”的“虚-邪-损”闭环病机模型,确立“补肾化瘀清泄”治疗原则。其临证依病程分期论治:慢性肾脏病1至2期属“外邪袭扰,邪入肾络”,用麻黄连翘赤小豆汤合金匮肾气丸补益肾气、祛风通络;慢性肾脏病3期为“痰湿瘀阻,脾肾两虚”,以苓桂术甘汤合济生肾气丸补益脾肾、化瘀利湿;慢性肾脏病4至5期属“水毒瘀结,肾气难复”,予真武汤合大黄附子汤加味扶正祛邪、化毒利浊。临床研究证实,该方案通过“补肾”与“化瘀清泄”的动态平衡,可显著改善症状、稳定肾功能;基于上述疗效机制,本研究系统梳理刘宝厚教授基于“正本清源”理论的慢性肾脏病诊疗体系,旨在传承名医学术思想,为中医规范化治疗提供参考,以提升临床疗效。
Chronic kidney disease(CKD)is a common urinary system disorder characterized by structural or functional impairment ofthe kidneys for at least 3 months.The global prevalence of CKD 13%.Clinical manifestations include edema,hypertension,proteinuria,ctc.It isprone to progress to end-stage renal disease and eventually requires dialysis or kidney transplantation to sustain life.Professor LIU Baohou,basedon the theory of“returning to the root and clarifying the source”in Huangdi Neijing(《黄帝内经》),proposed the principle of"treating both thesymptoms and the root cause,eliminating pathogentic factors and stabilizing the body".If blood stasis persists,it is diffieult for kidney Qi(气)to recover.Based on the core idea that"if damp-heat is not eliminated,protein is hard to be eliminated",a closed-loop pathogenesis model of"deficiency-pathogen-damage"is constructed with kidney Qi deficiency as the"root"and blood stasis and damp-heat as the"symptoms",andthe treatment principle of tonifying the kidney,removing blood stasis and clearing the bladder"is established.The clinical treatment is based on thestage of the disease:for CKD stages I to 2,it is characterized by"external pathogenic factors that invade the kidney meridians",and the decoctionsof the Mahuang Liangiao Chixiaodou decoction(麻黄连翘赤小豆汤)and the Jinkui Shenqi Pills are used to tonify kidney Qi,dispel wind andunblock the meridians.Stage 3 is characterized by"phlegm-dampness and blood stasis obstruction,and deficiency of both spleen and kidney".Thecombination of the Linggui Zhugan decoction(苓桂术甘汤)and the Jisheng Shenqi Pills(济生肾气丸)is used to tonify the spleen and kidney,remove blood stasis,so as to promote diuresis.For stages 4 to 5,it is characterized by"water toxins and blood stasis,and the kidney Qi is difficultto restore".The Zhenwu decoction is combined with the Dahuang Fuzi decoction to support the body's resistance,eliminate pathogenic factors,transform toxins and remove turbidity.Clinical research has confirmed that this regimen,through the dynamic balance of"tonifying the kidney"and"removing blood stasis and clearing the bowels",can significantly improve symptoms and stabilize renal function.Based on the above-mentionedtherapeutic mechanism,this article systematically reviews Professor LIU Baohou's chronic kidney disease diagnosis and treatment system basedon the"returning to the root and clarifying the source"theory,aiming to inherit the academic thoughts of famous doctors,provide references forstandardized treatment in traditional Chinese medicine,and improve clinical efficacy.