基于《四圣心源·劳伤解》辨治慢性肾脏病"血瘀"状态OA

"Blood stasis"is the core pathological state of chronic kidney disease(CKD),which runs through the whole course of the disease and is a key factor affecting its prognosis.Based on HUANG Yuanyu's academic thoughts in Consumptive Injury in Four Sages' Heart Source,combined with modern medical knowledge and the clinical experience of our team,this paper systematically explores the syndrome differentiation and treatment system of the"blood stasis"state in CKD.The"blood stasis"state can be seen in various syndrome types of CKD,with three syndrome types being the most typical:blood deficiency with stasis,dampness in the spleen and stagnation of the liver qi,and kidney deficiency with blood stasis.For the syndrome of blood deficiency with stasis,Guizhi Danpi Taoren Decoction(桂枝丹皮桃仁汤)combined with Dabuyuan Decoction(大补元煎)should be selected,focusing on tonifying qi and replenishing blood,promoting blood circulation to resolve stasis;for the syndrome of dampness in the spleen and stagnation of the liver qi,Zisu Jiangling Decoction(紫苏姜苓汤)with the addition of Chaihu(Bupleuri Radix)and Chuanniuxi(Cyathular Radix)should be selected,aiming at regulating qi and relieving depression,warming the spleen and removing dampness,and promoting blood circulation to remove stasis;for the syndrome of kidney deficiency with blood stasis,Poyu Decoction(破瘀汤),Yiqi Yangyin Taohong Siwu Decoction(益气养阴桃红四物汤),Erxian Decoction(二仙汤),etc.are selected,emphasizing on tonifying the kidney and supplementing essence,regulating yin and yang,and promoting blood circulation to remove stasis.A framework of syndrome-differentiated treatment centered on"regulating Zang-Fu viscera and promoting blood circulation to remove stasis"is constructed,highlighting the guiding value of HUANG Yuanyu's theory of consumptive injury in the diagnosis and treatment of CKD.It provides a theoretical basis and practical reference for the clinical syndrome differentiation and treatment of the"blood stasis"state in CKD in traditional Chinese medicine,and also provides a direction for in-depth research on the combination of classic theories and modem clinical practice.