[1]吕沁珂,钟建.基于“浊邪害清”理论探讨慢性肾脏病之因机证治[J].陕西中医,2026,(3):379-383.[doi:DOI:10.3969/j.issn.1000-7369.2026.03.017]
　LYU Qinke,ZHONG Jian.Clinical application of the traditional chinese medicine theory of turbid evil impairing clarity in chronic kidney disease[J].,2026,(3):379-383.[doi:DOI:10.3969/j.issn.1000-7369.2026.03.017]
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基于“浊邪害清”理论探讨慢性肾脏病之因机证治

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年3期
页码:
379-383
栏目:
学术探讨
出版日期:
2026-03-05

文章信息/Info

Title:
Clinical application of the traditional chinese medicine theory of turbid evil impairing clarity in chronic kidney disease
作者:
吕沁珂1; 钟建2
（1.广西中医药大学,广西 南宁 530200;2.广西中医药大学第一附属医院,广西 南宁 530023）
Author(s):
LYU Qinke1; ZHONG Jian2
（1.Guangxi University of Chinese Medicine,Nanning 530200,China;2.The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530223,China)
关键词:
浊邪害清; 慢性肾脏病; 中医病机; 证候分型; 中医治疗
Keywords:
Turbid pathogen damaging clarity; Chronic kidney disease; TCM pathogenesis; Syndrome differentiation; Traditional Chinese medicine
分类号:
R 692.9
DOI:
DOI:10.3969/j.issn.1000-7369.2026.03.017
文献标志码:
A
摘要:
慢性肾脏病以肾功能逐渐减退为特征，其病程迁延，病因复杂，对患者造成极大程度困扰。历代医家对本病治则众说纷纭，现结合钟建教授临床诊疗思路，以“浊邪害清”理论为切入点，提出“脾肾亏虚为本、浊邪演变为标”的核心病机，剖析病程中“本虚-湿热-痰瘀-毒积”的动态演变过程，在内脾肾亏虚，浊邪始生，以化生各类病理产物，尤以湿热为先，为疾病病变之始；互化痰瘀，充当疾病病理核心；病势反复，毒积肾络为疾病终末结局。今结合临证所察，治疗需分虚实缓急，以补脾益肾为总纲，前期-清透湿热截进展之势；中期，化痰活血除代谢沉积；后期，解毒澄源防癥积之变，进而减缓慢性肾脏病进展，并为构建中医辨证体系干预慢性肾脏病提供理论依据与临床路径参考。
Abstract:
Chronic kidney disease is characterized by the gradual decline of renal function.Its course of disease is prolonged and the etiology is complex,which causes great distress to patients.Doctors of all dynasties have different opinions on the treatment of this disease.Now,combined with Professor Zhong Jian’s clinical diagnosis and treatment ideas,the theory of “turbid evil harming the clear” is used as the starting point,and the core pathogenesis of “spleen and kidney deficiency as the root,turbid evil evolution as the symptom” is proposed.The dynamic evolution process of “root deficiency-damp heat-phlegm and blood stasis-toxic accumulation” in the course of the disease is analyzed.In the case of internal spleen and kidney deficiency,turbid evil begins to be generated,and various pathological products are generated,especially damp heat,which is the beginning of the disease pathology;phlegm and blood stasis are transformed into each other,which serves as the pathological core of the disease;the disease is repeated,and toxic accumulation in the kidney network is the final outcome of the disease.Combined with clinical observations,treatment needs to be divided into deficiency and excess,urgency and slowness,with tonifying the spleen and kidney as the general principle.In the early stage,clearing away dampness and heat to stop the progression;in the middle stage,resolving phlegm,activating blood circulation and removing metabolic deposits;in the late stage,detoxification and clearing the source to prevent the transformation of symptoms and accumulation,thereby slowing down the progression of chronic kidney disease,and providing a theoretical basis and clinical pathway reference for constructing a TCM syndrome differentiation system to intervene in chronic kidney disease.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（8226140498）；广西自然科学基金资助项目（2022JJA140201）；北京白求恩公益基金会资助项目（SCWLKY-050-001）
更新日期/Last Update: 2026-03-05