基于“治痿独取阳明”理论探讨针刺治疗慢性肾脏病肌少症作用机制

Exploring the Mechanism of Acupuncture Treatment for Sarcopenia in Chronic Kidney Disease Based on the Theory of “Exclusive Focus on Yangming Meridians for Treating Flaccidity”

摘要: 随着人口老龄化的进程加重，慢性肾脏病(chronic kidney disease, CKD)已然成为了当代重要的公共健康挑战。在长期发病过程中，由于胰岛素抵抗、激素紊乱、肠道菌群失调等多种因素导致蛋白质降解增加，合成减少，机体呈负氮平衡，致使肌肉力量或肌肉功能降低，日久易合并肌肉减少症，“治痿独取阳明”理论源自《黄帝内经》，强调阳明经在痿证治疗中的关键作用。肌少症在中医理论中可归属于“痿证”范畴，与阳明经气血不足、筋脉失养密切相关。基于此，从“治痿独取阳明”理论出发，探讨针刺治疗慢性肾脏病肌少症的作用机制，有望为临床治疗提供新的思路和方法，具有重要的理论和实践意义。

Abstract: With the increasing aging of the population, chronic kidney disease (CKD) has become a significant public health challenge in modern times. During its long-term course, multiple factors such as insulin resistance, hormonal disorders, and gut microbiota dysregulation lead to increased protein degradation, reduced synthesis, and negative nitrogen balance in the body, resulting in decreased muscle strength or function. Over time, this predisposes to sarcopenia. The theory of “exclusive focus on Yangming meridians for treating flaccidity” originates from the Huangdi Neijing, emphasizing the critical role of the Yangming meridians in the treatment of flaccidity syndromes. Sarcopenia can be categorized into the “flaccidity syndrome” in traditional Chinese medicine (TCM) theory, which is closely associated with qi-blood deficiency in the Yangming meridians and inadequate nourishment of the tendons and vessels. Based on this theoretical framework, exploring the mechanism of acupuncture treatment for CKD-related sarcopenia from the perspective of “exclusive focus on Yangming meridians for treating flaccidity” is expected to provide new insights and methods for clinical intervention, holding important theoretical and practical significance.