慢性肾衰竭病因病机古今通变

The Etiology and Pathogenesis of Chronic Renal Failure Have Changed throughout History

摘要: 慢性肾衰竭(Chronic Renal Failure, CRF)是各种慢性肾脏病持续进展的最终结局，以肾功能进行性减退、代谢废物潴留、水电解质及酸碱平衡紊乱为主要特征。近年来，其发病率在全球范围内呈逐年上升趋势，我国成人慢性肾脏病患病率已达10.8%，其中约10%~20%会逐步进展为慢性肾衰竭，严重威胁患者生命健康。现代医学针对慢性肾衰竭的治疗主要以控制血压、血糖、纠正电解质紊乱、透析替代治疗及肾移植为主，但透析治疗易引发多种并发症，肾移植则面临供体短缺、免疫排斥等问题，临床治疗仍存在诸多局限。中医药在慢性肾衰竭的治疗中积累了丰富的临床经验，其以整体观念、辨证论治为核心，在保护残存肾功能、延缓病程进展、改善临床症状、降低并发症发生率等方面具有独特优势。深入探讨古代医家与现代医家对慢性肾衰竭的病因病机的认识，对于丰富临床诊疗思路、提高患者生存质量具有重要的理论与实践意义。

Abstract: Chronic Renal Failure (CRF) is the ultimate outcome of the continuous progression of various chronic kidney diseases, mainly characterized by progressive decline of renal function, retention of metabolic wastes, and disorders of water, electrolytes and acid-base balance. In recent years, the incidence rate of chronic kidney disease has been increasing year by year worldwide. In China, the prevalence rate of chronic kidney disease among adults has reached 10.8%, among which about 10% to 20% will gradually progress to chronic renal failure, seriously threatening the life and health of patients. Modern medicine mainly focuses on the treatment of chronic renal failure by controlling blood pressure and blood sugar, correcting electrolyte imbalance, dialysis replacement therapy and kidney transplantation. However, dialysis treatment is prone to cause various complications, while kidney transplantation faces problems such as donor shortage and immune rejection. There are still many limitations in clinical treatment. Traditional Chinese medicine has accumulated rich clinical experience in the treatment of chronic renal failure. With the holistic concept and syndrome differentiation and treatment as its core, it has unique advantages in protecting the remaining renal function, delaying the progression of the disease, improving clinical symptoms, and reducing the incidence of complications. An in-depth exploration of the understanding of the etiology and pathogenesis of chronic renal failure by ancient and modern medical practitioners is of great theoretical and practical significance for enriching clinical diagnosis and treatment ideas and improving the quality of life of patients.