“伏毒损络”论治慢性肾脏病研究进展

Research progress on treatment of chronic kidney disease based on the theory of “volvotoxin damage collaterals”

关键词:  慢性肾脏病  络病理论  伏毒  中医治疗

Key words:  chronic kidney disease  collateral theory  latent toxin  traditional Chinese medicine therapy

摘要:

慢性肾脏病（CKD）是一类以肾脏结构或功能改变≥3个月为特征的慢性进展性疾病。络脉理论指导疑难杂病治疗临床疗效显著，肾小球血管迂曲细窄，与中医络脉特征相一致，肾脏与络脉间存在密切相关性。文章对络脉的生理、病理特点进行概述，以络脉理论为基础，从伏毒损络切入，探讨络脉病变与CKD发病机制与治疗的联系。基于络脉易滞易瘀的特点，络病“不通”的病机实质，故“络以通为用”为络病的基本治疗原则。提出CKD治疗在临证组方中应辨证选用解毒泄浊、补虚通络之品，以期为临床治疗CKD提供参考。

Abstract:

Chronic kidney disease(CKD) is a progressive condition defined by structural/functional renal abnormalities persisting ≥ 3 months. The collateral theory in Traditional Chinese Medicine(TCM) has shown significant efficacy in treating refractory diseases. Glomerular vessels, with their tortuous and narrow morphology, align with TCM's collateral characteristics, suggesting a close kidney-collateral relationship. This paper summarizes the physiology and pathology of collaterals, then explores how “latent toxin-induced collateral injury” contributes to CKD pathogenesis and treatment. Given collaterals' susceptibility to stagnation and the core pathogenesis of “obstruction”, the principle of “promoting collateral patency” is fundamental. We propose that CKD treatment should incorporate herbs for toxin clearance, turbidity elimination, deficiency tonification, and collateral activation, offering a TCM-guided therapeutic framework.