基于“气-血-水”理论的慢性肾脏病辨治思路与研究进展
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丁忠瑞
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长春市中医院，吉林长春，130052
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摘要：“气 -血 -水”理论源于《黄帝内经》，由张仲景奠定辨证基础，经后世医家发展而日臻完善。慢性肾脏病（CKD）病程缠绵，病机复杂，核心在于肾气受损，进而导致血瘀、水停，三者相互交结、互为因果。本文系统探讨“气 -血 -水”理论的核心内涵及其在CKD病机演变中的作用，总结现代医家基于该理论的临床辨治思路，并结合专家问卷调查、肾络癥瘕理论及结缔组织生长因子（connective tissue growth factor，CTGF）等分子标志物分析其现代生物学基础。研究表明，“补气、活血、利水”三法并举，切中CKD“本虚标实”之病机，是延缓疾病进展的重要策略。
关健词：慢性肾脏病；气血水理论；气虚；血瘀；水停 |
Diagnosis and Treatment Approaches to Chronic Kidney Disease Based on the “Qi-Blood-Water” Theory: Research Progress
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Zhongrui Ding
Changchun Hospital of Traditional Chinese Medicine,Changchun Jilin 130052 china
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Abstract: The “Qi-Blood-Water” theory originates from the Huangdi Neijing, with Zhang Zhongjing establishing its diagnostic foundation, and has been further developed and refi ned by later physicians. Chronic kidney disease (CKD) is characterized by a prolonged course and complex pathogenesis, primarily involving defi ciency of kidney Qi, which subsequently leads to blood stasis and fl uid retention—three factors that interweave and mutually reinforce each other. This article systematically explores the core principles of the “Qi-Blood-Water” theory and its role in the pathogenic evolution of CKD, summarizes contemporary clinical approaches based on this theory, and integrates expert questionnaire surveys, the theory of renal network syndrome and phlegm masses, as well as molecular markers such as CTGF, to analyze its modern biological basis. Studies indicate that the combined application of tonifying Qi, activating blood circulation, and promoting diuresis precisely targets the CKD pathogenesis of “underlying defi ciency and superfi cial excess,” representing a crucial strategy for slowing disease progression.
Keywords : chronic kidney disease; Qi-Blood-Water theory; Qi defi ciency; blood stasis; fl uid retention
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