摘要
“三阴结谓之水”是《素问·阴阳别论》中对于水肿病病机的高度概括,后世治疗水气病的理论多源于此。此论意指肺脾肾三脏气机不利,水液代谢异常而成水肿,而糖尿病肾脏病水肿亦是正虚邪实,肺脾肾三脏气机不利,结而为水。“三阴结”的具体病机变化为热伤气阴,外邪袭肺,肺失宣降,通调失司而结;脾虚湿热,湿瘀互结,耗伤气阴,运化失常而结;肾虚血瘀,癥瘕内结,风伏络脉,气化失职而结。三脏常相兼为病,治疗需辨明病机,多脏兼顾,应用健脾补肾同施、利湿活血共用等治法,方能达到理想疗效。
"San Yin Jie Wei Zhi Shui"is a highly summarized explanation of the pathogenesis of edema in Su Wen·Ying Yang Bie Lun,which has influenced the treatment theories of Dampness-related diseases in later generations.This theory means that edema results from the dysfunction of the Lung,Spleen,and Kidney Qi mechanisms,leading to abnormal Water metabolism.Similarly,diabetic nephropathy edema is characterized by"deficiency of Zheng Qi and excess of the Evil Factors"inducing the dysfunction of the Lung,Spleen,and Kidney Qi mechanisms and then the accumulation of Water.The specific pathophysiological changes of the"San Yin Jie"are as follows:Heat injures Qi and Yin,external pathogens invade the Lung,the Lung loses its Qi dispersing and descending function,and dredging and regulating dysfunctions of the Lung are brought about,leading to Water accumulation;When there is Spleen deficiency with Damp-Heat syndrome,mutual accumulation of Dampness and stasis is caused,which damages Qi and Yin,causing abnormal transportation and accumulation of Water;Kidney deficiency with blood stasis,internal accumulation of masses and Wind concealing in the collaterals induce impaired Qi Hua and Water accumulation.The three Zang often suffer simultaneously,so treatment should be carried out to clarify the pathogenesis,address the multiple Zang,with therapies such as strengthening the Spleen and tonifying the Kidney as well as relieving Dampness and activating blood circulation to achieve ideal therapeutic effects.
作者
王羽
李潇然
黄为钧
王世东
WANG Yu;LI Xiaoran;HUANG Weijun;WANG Shidong(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing China 100700;Beijing University of Chinese Medicine,Beijing China 100029)
出处
《中医学报》
2025年第12期2560-2563,共4页
Acta Chinese Medicine
基金
国家重点研发计划项目(2018YFC1704402)。
关键词
糖尿病肾脏病水肿
“三阴结谓之水”
肺结
脾结
肾结
病机
diabetic nephropathy edema
San Yin Jie Wei Zhi Shui
Lung related Water accumulation
Spleen related Water accumulation
Kidney related Water accumulation
pathogenesis
