摘要
慢性肾脏病(CKD)患者是新型冠状病毒(简称“新冠”,COVID-19)感染的易感及高危人群,COVID-19累及肾脏可出现肾功能减退甚至慢性肾脏病基础上急性肾损伤。新冠感染导致CKD进展的关键病因为体虚邪凑、内外合邪,主要病机包括:肾气亏虚为病理基础,肾络瘀结为核心病机,肺肾同损为预后不良原因,气阴两虚为新冠愈后肾功能未恢复原因。临床需分期论治,未病应养正固本、避其邪气,已病需益气化瘀、肺肾同治,瘥后当益气养阴、荡涤余邪。
Patients with chronic kidney disease(CKD) are susceptible to and at high risk of coronavirus disease 2019(COVID-19).COVID-19 can cause renal dysfunction and even acute kidney injury in patients with CKD.The key pathogenic factors for the progression of CKD caused by COVID-19 are deficiency of vital energy and invasion of pathogenic factors,both internally and externally.The main pathological mechanisms include:kidney-qi deficiency as the pathological basis,stasis of the kidney collaterals as the core mechanism,lung-kidney impairment as the reason for poor prognosis,and deficiency of both qi and yin as the reason for the failure of kidney function to recover post COVID-19 convalescence.Clinical treatment should be staged according to the disease progression.In the pre-disease stage,efforts should focus on strengthening the body's constitution and avoiding pathogenic influences.In the active disease stage,treatment should aim to tonify qi,resolve blood stasis,and concurrently address lung and kidney issues.In the post-recovery stage,treatment should focus on replenishing qi,nourishing yin,and eliminating any residual evils.
作者
王悦
孙鲁英
姚志
尚唱
WANG Yue;SUN Luying;YAO Zhi;SHANG Chang(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Fangshan Hospital,Beijing University of Chinese Medicine)
出处
《现代中医临床》
2024年第3期73-77,共5页
Modern Chinese Clinical Medicine
基金
国家重点研发计划项目(No.2018YFC1704304)。
