| 引用本文:李子涵，张琪琪，马晨稀，袁静雅，张琳.慢性肾衰竭通腑泄浊法衍义[J].世界中医药,2023,(06):. |
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| 慢性肾衰竭通腑泄浊法衍义 |
| Dredging Fu-organs and Descending the Turbid for Chronic Renal Failure |
| 投稿时间：2021-07-22 |
| DOI：10.3969/j.issn.1673-7202.2023.06.014 |
| 中文关键词: 慢性肾衰竭 通腑泄浊法 腑以通为用 邪有出路 通达气机 通利小便 通畅肠腑 中医外治法 |
| English Keywords:Chronic renal failure Dredging fu-organs and descending the turbid The six fu-organs functioning well when unobstructed Maintaining the path for the pathogens to be expelled Smoothing the movement of qi Promoting the excretion of urine Dredging fu-organs External treatment of Chinese medicine |
| 基金项目:国家自然科学基金项目（81503509） |
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| 中文摘要: |
| 代谢毒素的产生和潴留是慢性肾衰竭的显著特点。改善代谢毒素产生的内环境，减少代谢毒素生成并增加其排泄，是阻止慢性肾衰竭进展的重要环节。中医学理论认为，慢性肾衰竭的病机特点为本虚标实，以脾肾亏虚为本，以水湿、湿热、瘀血、浊毒等邪实为标，久病则湿、瘀、毒蕴结。邪实既是慢性肾衰竭的病理产物，又诱导疾病进展。《温热逢源》言“盖脏病无出路，必借道于腑，乃能外出”，六腑可为邪实之出路，故六腑通则邪实输泻有余。通腑泄浊法以邪实为标靶，是慢性肾衰竭在扶正固本之外的治标之法。狭义的通腑泄浊法功同下法，临床应用范围较局限，应进一步阐释其内涵，拓展其应用范围以适应临床需要。广义的通腑泄浊法当重恢复六腑“以通为用”“以降为顺”的生理特性，给予邪实以出路，并“攻邪已病”。根据邪实的特性因势利导，使之排出体外，邪去则正安，主要包括通达气机、通利小便、通畅肠腑3个方面。 |
| English Summary: |
| The production and retention of toxins are the major features of chronic renal failure(CRF).Restoring the internal environment to reduce the production and increase the excretion of metabolic toxins is an important measure to prevent the progression of CRF.According to the theory of traditional Chinese medicine，CRF is rooted from the deficiency of spleen and kidney，with the superficial causes of dampness，dampness-heat，blood stasis，and turbid toxin.The lingering of this disease results in the accumulation of dampness，stasis，and toxin.Pathogenic factors are not only the pathological products of CRF but also induce the progression of CRF.The book Wen Re Feng Yuan says that the pathogenic factors produced by the metabolism of the zang-organs needs to be excreted through the fu-organs.The pathogenic factors will not be retained when the six fu-organs are unobstructed，which are considered as the passage out of the body.Targeting at the pathogenic factors，dredging fu-organs and descending the turbid is a palliative method for CRF in addition to the method of reinforcing healthy qi and consolidating the root，which targets at the root cause.In a narrow sense，the function of dredging fu-organs and descending the turbid is purging.This single function limits the clinical application of this method.Therefore，the connotation of this method should be further explained and the application scope should be expanded to meet clinical needs.In a broad sense，the method of dredging fu-organs and descending the turbid focuses on the recovery of the physiological activities of six fu-organs，which are kept unobstructed to maintain the path for the pathogenic factors to be expelled.In summary，the method includes three aspects：smoothing the movement of qi，promoting the excretion of urine，and dredging fu-organs. |
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