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彭亚平, 邹译娴, 王行宽.王行宽教授论治肾性高血压经验撷菁[J].湖南中医药大学学报,2025,45(6):1100-1104[点击复制] |
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| 王行宽教授论治肾性高血压经验撷菁 |
| 彭亚平,邹译娴,王行宽 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 肾性高血压是慢性肾脏病最常见的并发症之一，首届全国名中医王行宽教授认为其病机核心为肾精气亏虚、水湿不化，封藏失职，营精暗泄，病延既久，进而致使肾藏真虚衰，溺毒内生，水不涵木，肝阳继而上亢而成。临证中肾性高血压患者常因水钠潴留致阳亢难平、肾元虚衰碍药效受限等因素，血压较难达标。王行宽教授取法“乙癸同源”精义，擅长“多脏调燮”之法：治本滋肾以涵肝木，疏肝以平木亢，实脾以制水邪；治标则以清泻溺毒、祛痰活血为精要，同时重视“微观辨病辨证”，将现代理化指标纳入“司外揣内”辨证体系，取标本兼施、燮理阴阳而达平肝潜阳之效。王行宽教授历经六十载临床验证，融汇经典理论与现代认知的诊疗体系，验之临床，效显而理彰，为肾性高血压的诊治提供了经典思维与现代实践结合的范例。 |
| 关键词: 肾性高血压 藏真虚衰 溺毒 痰瘀互结 微观辨病辨证 王行宽 |
| DOI：10.3969/j.issn.1674-070X.2025.06.017 |
| 投稿时间：2025-01-20 |
| 基金项目:第七批全国老中医药专家学术经验继承项目(国中医药人教函〔2022〕76号)；湖南省中医药管理局基金项目（D2022009）。 |
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| Essence of Professor WANG Xingkuan's experience in treating renal hypertension |
| PENG Yaping, ZOU Yixian, WANG Xingkuan |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Renal hypertension is one of the most common complications of chronic kidney disease. Professor WANG Xingkuan, a national famous TCM practitioner, holds the view that the core pathogenesis of renal hypertension lies in kidney essence and qi deficiency, impaired transformation of water-dampness, loss of the kidney's function in sealing and storing, thereby leading to the subtle leakage of essence and nutrients. Over time, this condition progresses to profound deficiency of kidney Yuan-primordial qi, the generation of endogenous "urine toxins", failure of kidney (water) to nourish the liver (wood), and subsequent hyperactivity of liver yang. Clinically, patients with renal hypertension often face challenges in achieving blood pressure control due to factors such as sodium and water retention, which make it difficult to submerge hyperactive yang, and the impairment of drug efficacy caused by kidney Yuan-primordial qi deficiency. Drawing inspiration from the profound principle of "kidney (Yi) and liver (Gui) sharing a common source", Professor WANG excels in the approach of "regulating multiple organs harmoniously". For the root cause, he tonifies the kidney to nourish the liver (wood), soothes the liver to submerge its hyperactivity, and strengthens the spleen to restrain water-dampness; for the manifestations, he focuses on clearing and draining urine toxins, eliminating phlegm, and circulating blood as the key strategies. Meanwhile, he emphasizes "microscopic differentiation of diseases and patterns", incorporating modern laboratory and physical examination indicators into the pattern identification system of "inferring the internal from the external", thereby achieving the effects of soothing the liver and submerging yang through a comprehensive approach that addresses both the root and the manifestations and harmonizes yin and yang. After six decades of clinical verification, Professor WANG Xingkuan has developed a diagnostic and therapeutic system that integrates classical TCM theories with modern medical knowledge. This system has demonstrated remarkable efficacy and is theoretically well-founded in clinical practice, providing an exemplary model for combining classical TCM thinking with modern medical practice in the diagnosis and treatment of renal hypertension. |
| Key words: renal hypertension kidney Yuan-primordial qi deficiency urine toxin intermingled phlegm and blood stasis microscopic differentiation of diseases and patterns WANG Xingkuan. |
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