余仁欢基于"心部于表,肾治于里"从营卫辨治Ⅳ型心肾综合征OA
YU Renhuan's Differentiation and Treatment of Type Ⅳ Cardiorenal Syndrome from Ying and Wei Based on"The Heart Governs the Exterior,The Kidney Governs the Interior"
"心部于表,肾治于里"提示心肾具有化生输布营卫、调节气血运行功能,为从营卫角度论治Ⅳ型心肾综合征提供了理论基础.余仁欢教授总结Ⅳ型心肾综合征稳态病机及动态病机规律,即稳态病机为全周期营郁卫滞,动态病机包括缓解期肾虚为本,营卫不充则化生郁滞,慢性期急性发作心虚受邪,营卫失和,内外合邪加剧郁滞,晚期心肾耗竭,营卫衰少,久郁成毒.临证治疗时据分期之差而偏重各异.此外,余教授强调临床中应尽早进行中西医结合对症治疗,以求截断疾病进展.附验案1则.
The theory that"the heart governs the exterior while the kidney governs the interior"suggests that the heart and kidney are responsible for generating,transforming,and distributing Ying-Wei,as well as regulating the circulation of qi and blood.This provides a theoretical foundation for treating type ⅣCardiorenal Syndrome(CRS)from the perspective of Ying-Wei.Professor YU Renhuan summarizes the pathophysiological patterns of type Ⅳ CRS into stable and dynamic states.The stable pathogenesis is characterized by universal constraint and stagnation of Ying-Wei throughout the entire disease cycle.The dynamic pathogenesis varies by stage,in remission stage,kidney deficiency serves as the root cause and insufficient Ying-Wei leads to impaired generation and subsequent stagnation;in chronic stage with acute exacerbation,heart deficiency allows exogenous pathogens to invade,the discordance of Ying-Wei and the combination of internal and external pathogens exacerbate the stagnation;in end-stage:heart and kidney exhaustion results in severe depletion of Ying-Wei,where prolonged stagnation transforms into toxicity.Clinical treatment is tailored according to these stages,with varying therapeutic priorities.Furthermore,Professor YU emphasizes the importance of early and aggressive integrated Chinese and Western medicine for symptomatic control,aiming to intercept the progression of the disease.One test case is attached.
詹添;王湘鹏;展婧怡;王文茹;杨嘉仪;燕燕;陈瑶;梁莹
中国中医科学院西苑医院肾病科,北京 100091北京市丰台区中医医院肾病科,北京 100076中国中医科学院西苑医院肾病科,北京 100091中国中医科学院西苑医院肾病科,北京 100091中国中医科学院西苑医院肾病科,北京 100091中国中医科学院西苑医院肾病科,北京 100091中国中医科学院西苑医院肾病科,北京 100091中国中医科学院西苑医院肾病科,北京 100091
医药卫生
Ⅳ型心肾综合征心部于表肾治于里营卫分期论治余仁欢
type Ⅳ cardiorenal syndromeheart governs the exteriorkidney governs the interiorYing-Weistaged treatmentYu Renhuan
《山东中医杂志》 2026 (6)
642-647,6
国家自然科学基金青年科学基金项目(编号:82305223)中国中医科学院西苑医院余仁欢名老中医经验传承与创新研究项目(编号:XYZX0101-22)
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