基于“开阖枢”理论探讨以“和解少阴”论治心肾综合征

Discussion on the treatment of cardiorenal syndrome with “reconciling Shaoyin” based on the theory of “Open-Shut-Pivot”

关键词:  心肾综合征  开阖枢  和解少阴

Key words:  cardiorenal syndrome  Open-Shut-Pivot  reconciling Shaoyin

摘要:

心肾综合征是指当心脏和肾脏其中某一器官发生功能异常从而导致另一器官功能异常的综合征。开阖枢理论起源于《黄帝内经》，《伤寒论》中依据“开阖枢”理论阐释六经之经气流转，并以少阳为三阳经之枢，少阴为三阴经之枢。后世医家常基于三阴三阳开阖枢理论辨治心肾综合征，但现代医家以和解少阳法辨治心肾综合征者颇多，少有以少阴为枢论治心肾综合征者，而心肾综合征病程长，病机复杂，尤宜“和解少阴”之法，以《伤寒论》中“和解少阴”之法衍生出沟通阴阳、疏利气机、调和水火等治法，为临床治疗慢性心肾综合征提供了新的诊疗角度。

Abstract:

Cardiorenal syndrome （CRS） is a syndrome in which one of the organs of the heart and kidneys is dysfunctional，leading to the dysfunction of the other organ. The theory of Open-Shut-Pivot originated from the The Inner Canon of Huangdi，which is used to describe the movement changes of the six qi of yin and yang. In Treatise on Febrile Diseases，the theory of “Open-Shut-Pivot” is used to explain the circulation of the channels and qi of the six channels，and Shaoyang is regarded as the pivots of three yang channels，Shaoyin as the pivots of three yin channels. Later doctors often used the theory of “Open-Shut-Pivot” of three yin and three yang to treat the pathogenesis of “cardinal disorder” of CRS. However，many modern doctors treated heart-kidney syndrome with the method of reconciling Shaoyang，and few treat heart-kidney syndrome with Shaoyin as the focal point. However，heart-kidney syndrome has a long course of disease and complicated pathogenesis，so the method of “reconciling Shaoyin” suits it very well. Base on the method of “reconciling Shaoyin” in Treatise on Febrile Diseases，this paper derives the methods of communicating yin and yang，thinning qi and regulating fire and water，etc. It provides a new perspective of diagnosis and treatment for chronic cardiorenal syndrome in clinical practice.