王瑶 张李博 吴金鸿 刘光珍

    〔摘要〕 国家级名中医刘光珍治疗慢性肾脏病(chronic kidney disease， CKD)強调分期治疗：CKD 1-3a期以脾肾亏虚为主，以补益脾肾为主要治法;CKD 3b-4期以脾肾亏虚、湿热瘀毒胶结为主，治以补益脾肾，配合利湿泄浊，活血化瘀;CKD 5期脾肾衰败、湿热瘀毒弥漫，易生诸多变证，治以回阳救逆为主，针对变证随证治之。刘教授指出CKD病机总以脾肾亏虚为本，湿、热、瘀、毒为标，其病机发展呈“本愈虚，邪愈实”的特点，治疗时灵活运用补肾健脾，利湿化浊，活血化瘀之法，擅长应用经方、药对治疗本病，并自拟CKD经验方(黄芪、当归、党参、白术、苍术、茯苓、砂仁、赤芍、丹参、薏苡仁、石韦、白茅根、续断、杜仲、狗脊、生龙骨、牡蛎)以适应病机变化。

    〔关键词〕 慢性肾脏病;分期治疗;刘光珍;医案

    〔中图分类号〕R256.5? ? ? 〔文献标志码〕B? ? ? ? 〔文章编号〕doi：10.3969/j.issn.1674-070X.2022.03.020

    〔Abstract〕 Liu Guangzhen， a national famous Chinese medicine practitioner， emphasizes staged treatment in the treatment of chronic kidney disease (CKD)： CKD stages 1-3a are mainly based on spleen and kidney deficiency， and the main treatment is to nourish the spleen and kidney; CKD stages 3b-4 are mainly deficiency of the spleen and kidney， damp-heat stasis and poison， and the treatment is to nourish the spleen and kidney， cooperated with dissipating dampness to remove turbidity， promote blood circulation and remove blood stasis; CKD stage 5 is mainly spleen and kidney failure， damp-heat and blood stasis toxin diffuse ......