余仁欢运用心肾同治法分型辨治心肾综合征

Yu Renhuan's application of simultaneous treatment of the heart and the kidney for the pattern-based treatment of the cardiorenal syndrome

摘要

心肾综合征是由于心脏或肾脏的急性或慢性功能障碍所引发的另一器官的相应损伤，这一临床综合征的病因和发病机制较为复杂。余仁欢教授认为其核心病机在于心肾亏虚为本，水湿、痰浊、血瘀互结为标，心肾水火既济失调。临证强调心肾同治，以辨证论治为核心，结合分型论治，分别施以益气温阳、活血利水、滋阴交泰、祛湿化痰等法，临床疗效显著。本文系统总结其辨证思路与分型论治经验，以期为心肾综合征的中医诊疗提供参考。

Abstract

Cardiorenal syndrome (CRS) is a clinical syndrome in which acute or chronic dysfunction of either the heart or the kidneys leads to corresponding impairment in the other organ. The etiology and pathogenesis of this syndrome are complex. Professor Yu Renhuan proposes that its core pathogenesis lies in deficiency of the heart and kidneys as the root, and mutual binding of water-dampness, phlegm-turbidity, and blood stasis as the manifestations, resulting in the imbalance of the heart-kidney water-fire interaction. In clinical practice, he emphasizes simultaneous treatment of the heart and kidney, with pattern differentiation and treatment as the core approach. Based on pattern classification, therapies such as replenishing qi and warming yang, activating blood circulation and promoting diuresis, nourishing yin and regulating heart-kidney communication, as well as dispelling dampness and resolving phlegm are applied accordingly, achieving significant clinical efficacy. This article systematically summarizes his diagnostic and therapeutic reasoning, as well as his experience in pattern-based treatment, aiming to provide a reference for the Traditional Chinese Medicine diagnosis and management of CRS.

关键词

心肾综合征 / 心肾同治 / 分型辨治 / 名医经验

Key words

cardiorenal syndrome / simultaneous treatment of the heart and kidney / pattern-based treatment / clinical insights of a master physician

参考文献

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基金资助

国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教函〔2022〕76号)

中国中医科学院科技创新工程(CI2024E005YB)