摘要
便秘是慢性肾脏病(Chronic kidney disease,CKD)患者的常见并发症之一,虽然通常被认为是一种良性及自限性症状,但越来越多的研究表明,便秘可能是CKD的独立危险因素,且和不良预后相关,这对患者的生活和病情控制造成了不利影响。李顺民教授认为,CKD患者出现便秘的本质是肾脏失调、三焦不和,其善于从“肾与三焦相通”论治CKD便秘,提出上焦降肺、中焦健脾、下焦补肾、气血同调的治疗策略。临床中,李顺民教授根据患者肾阴、肾阳亏虚程度的不同,治法略有差异。肾阳虚者,常以补骨脂、肉苁蓉等补肾助阳;肾阴虚者,则以生地黄、玄参、麦冬等滋阴润燥。同时调和三焦,重在中、下焦,兼顾上焦,注重疏通气血,习惯用紫苏叶、陈皮等疏通气机,丹参、大黄等活血化瘀。在治疗CKD便秘方面取得了良好疗效。
Constipation is one of the common complications of chronic kidney disease(CKD).Although constipation is generally considered a benign and self-limiting symptom,there is increasing evidence that constipation may be an independent risk factor for CKD and is associated with poor prognosis,which adversely affects patients'lives and disease control.Professor LI Shunmin believes that the essence of constipation in CKD patients is kidney disorder and triple energizer disharmony.Excelling in treating CKD constipation from the perspective of“connection between kidney and triple energizer”,he proposes the treatment strategy of regulating upper energizer to descend lungs,regulating middle energizer to invigorate spleen,regulating lower energizer to tonify kidney,and harmonizing both qi and blood.In clinic,Prof LI slightly adjusts the treatment according to various degrees of kidney yin and yang deficiency.For patients with kidney yang deficiency,Psoraleae Fructus and Cistanches Herba are often used to tonify kidney and assist yang,while for patients with kidney yin deficiency,Rehmanniae Radix Recens,Scrophulariae Radix,and Ophiopogonis Radix are used to nourish yin and moisten dryness.Simultaneously,triple energizer is harmonized,focusing on the middle and lower energizer while taking the upper energizer into account.Additionally,attention is paid to dredging qi and blood,and it is customary to use Perillae Folium and Citri Reticulatae Pericarpium to dredge qi movement,as well as Salviae Miltiorrhizae Radix Et Rhizoma and Rhei Radix et Rhizoma to activate blood and resolve stasis.Satisfactory efficacy has been achieved from the above treatment for CKD constipation.
作者
邓茜
李顺民
DENG Qian;LI Shun-min(Shenzhen Traditional Chinese Medicine Hospital,Shenzhen Guangdong 518033)
出处
《世界中西医结合杂志》
2025年第11期2181-2185,共5页
World Journal of Integrated Traditional and Western Medicine
基金
深圳市‘医疗三名工程’项目资助(SZZYSM202311004)
广东省中医药局科研项目(20251315)。
关键词
慢性肾脏病
三焦
便秘
Chronic Kidney Disease
Triple Energizer
Constipation
