辨证论治慢性肾衰竭患者胃肠道症状的理论探讨

消化系统症状作为贯穿慢性肾衰竭（CRF）病程始终的重要临床表现，病机多变，临床治疗复杂。胃肠道症状严重与否是影响CRF患者预后的危险因素之一。中医认为CRF患者脾肾虚损，中焦运化功能失和，或又因肝失疏泄，气机升降失调，导致消化系统一系列症状如恶心呕吐，呃逆嗳气等产生。脏腑失和，痰湿瘀血内生，日久成毒，进一步加重消化道症状。久则因实致虚，脾胃虚弱至气血阴阳俱虚。故治疗上以扶正祛邪为主要原则，强调通调气机、泄浊排毒、攻补兼施，多脏腑联合论治，在临床中取得了显著效果。本文通过进一步总结中医辨证论治CRF消化系统症状临床经验，为CRF患者胃肠道症状治疗提供新的思路与方法。

Theoretical discussion on treating gastrointestinal symptoms in patients with chronic renal failure based on syndrome differentiation

Gastrointestinal symptoms,as an important clinical manifestation throughout the course of chronic renal failure (CRF),have a variable pathogenesis and complex clinical treatment. The severity of gastrointestinal symptoms is one of the risk factors affecting the prognosis of CRF patients. According to traditional Chinese medicine theory,CRF patients suffer from deficiency of spleen and kidney,loss of harmony between the transport and transformation functions of zhong jiao,or loss of drainage of the liver,resulting in imbalance in the elevation of qi,leading to a series of symptoms in the digestive system such as nausea and vomiting,erratic belching,etc. When the internal organs are out of harmony,phlegm,dampness and blood stasis are generated internally and become toxic over time,further aggravating the digestive symptoms. In the long run,deficiency is caused by actuality,and weakness of the spleen and stomach leads to deficiency of the qi,blood,yin and yang. Therefore,treatment is based on the main principle of helping the righteous and eliminating the evil,emphasizing the regulation of qi,draining and detoxifying,attacking and supplementing at the same time,and the joint treatment of multiple internal organs,which has achieved remarkable results in clinical practice. In this paper,we further summarize traditional Chinese medicine''s clinical experience in the treatment of gastrointestinal symptoms in CRF,with the aim of providing new ideas and methods for the treatment of gastrointestinal symptoms in CRF patients.