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李伟军, 李谟文, 廉坤, 孟骊冲, 方格, 胡思远, 胡志希.基于“浊阴理论”探讨Ⅱ型心肾综合征的病机和证治[J].湖南中医药大学学报英文版,2025,45(8):1506-1511.[Click to copy
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| 基于“浊阴理论”探讨Ⅱ型心肾综合征的病机和证治 |
| 李伟军,李谟文,廉坤,孟骊冲,方格,胡思远,胡志希 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药高等专科学校, 湖南 株洲 412000) |
| 摘要: |
| Ⅱ型心肾综合征（CRS）作为临床常见的慢性进展性疾病，其病理机制涉及多系统交互作用。现代医学治疗体系主要聚焦于心肾功能的代偿平衡调控，通过维持心血管血流动力学稳定、优化肾脏灌注压、精准容量管理及抗炎干预等综合手段进行疾病管理。本研究基于《黄帝内经》“浊阴理论”的学术精髓，结合现代病理生理学研究进展，创新性提出“浊阴逆乱”是Ⅱ型CRS的核心病机。具体而言，浊阴代谢障碍在疾病进程中呈现三维病理特征：一为“浊阴不运”，二为“浊阴不化”，三为“浊阴不利”。针对此三联病理机制，确立“运-化-利”三位一体的治疗策略：运浊阴以复气机，化浊阴以清毒瘀，利浊阴以通玄府。在具体治法层面，提出“温阳固本、涤痰逐瘀、化气行水”的整合治疗方案，总结金匮肾气丸、瓜蒌薤白白酒汤、真武汤等方在治疗Ⅱ型CRS方面的优势。 |
| 关键词: Ⅱ型心肾综合征 浊阴理论 辨证论治 水肿 病因病机 |
| DOI：10.3969/j.issn.1674-070X.2025.08.016 |
| Received:March 19, 2025 |
| 基金项目:国家自然科学基金项目(82274412);国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023147) |
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| Pathogenesis and treatment based on pattern identification of type Ⅱcardiorenal syndrome based on "turbid yin theory" |
| LI Weijun, LI Mowen, LIAN Kun, MENG Lichong, FANG Ge, HU Siyuan, HU Zhixi |
| (Hunan University of Chinese Medicine, Changsha, Hunan, 410208, China;Hunan Traditional Chinese Medical College, Zhuzhou, Hunan 412000, China) |
| Abstract: |
| Type Ⅱ cardiorenal syndrome（CRS）, a clinically common chronic progressive disease, involves multisystem interactions in its pathological mechanisms. Modern medical treatment systems primarily focus on compensatory balance regulation of cardiorenal functions, employing integrated approaches such as maintaining cardiovascular hemodynamic stability, optimizing renal perfusion pressure, precise volume management, and anti-inflammatory interventions for disease management. This study,based on the academic essence of the "turbid yin theory" from the Huang Di Nei Jing（Huangdi’s Classic of Medicine） and integrated with modern pathophysiological research advancements, innovatively proposes that "turbid yin dysregulation" constitutes the core pathogenic theory of type Ⅱ CRS. Specifically, metabolic dysfunction of turbid yin manifests three-dimensional pathological features in the disease process, namely, "impaired transportation of turbid yin", "impaired transformation of turbid yin", and "impaired excretion of turbid yin". Addressing these tripartite pathological mechanisms, a "transportation-transformationexcretion trinity" therapeutic strategy is established: transporting turbid yin to restore qi movement, transforming turbid yin to eliminate toxic stagnation, and excreting turbid yin to unblock the mysterious mansion. At the level of specific treatment, an integrated regimen of "warming yang to consolidate the foundation, transforming phlegm and expelling stasis, and warming qi to promote water circulation" is proposed, highlighting the advantages of classical formulas such as Jingui Shenqi Pill, Gualou Xiebai Baijiu Decoction, and Zhenwu Decoction in treating type Ⅱ CRS. |
| Key words: type Ⅱ cardiorenal syndrome turbid yin theory treatment based on pattern identification edema etiology and pathogenesis |
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