基于“温肾化气，利湿泻浊”理论探讨肾性贫血的辨治

Discussion on the differentiation and treatment of renal anemia based on the theory of “warming the qi of kidney，relieving dampness and eliminating turbidity”

关键词:  慢性肾脏病  贫血  中西医结合  理论

Key words:  chronic kidney disease  anaemia  integrated of traditional Chinese and Western medicine  theory

摘要:

肾性贫血是慢性肾脏病的常见并发症之一。随着残存肾功能的恶化，贫血程度不断加重；严重贫血者可诱发心脑血管疾病的急性发作，影响患者生活质量。虚实夹杂、本虚标实的病机贯穿该病始终，脾肾亏虚为本，痰湿、浊毒阻络为标，主要累及脏腑为肝、脾、肾。治疗上当温补肾气与祛浊毒邪兼顾，益气补血并用，肝、脾、肾同治，补虚的同时不忘通腑利湿泻浊，以平补、轻补为主，调畅气机，补而不滞。

Abstract:

Renal anaemia is one of the common complications of chronic kidney disease. As the remaining renal function declines，the degree of anemia was aggravated. Severe anemia can precipitate acute bouts of cardiovascular and cerebrovascular disorders，impairing the patient’s quality of life. The pathogenesis of deficiency and excess mixed with deficiency and excess is throughout the disease. The disease is mostly caused by spleen and kidney deficiency. Blood stasis，phlegm-dampness，and turbid toxins also obstruct the ligaments and contribute to the condition. The liver，spleen，and kidney are the principal organs affected. In order to correct the deficit，the treatment should be combined the warming of qi of kidney，elimination of turbidity and toxins，the use of qi to tonify blood，and the liver，spleen，and kidneys should all be treated at the same time，and the tonification of deficiencies without forgetting to dredge the internal organs to relieve dampness，remove turbidity，and the use of flat and light tonics to regulate the qi flow，without stagnation.