老年继发性慢性肾脏病病因病机及分型述评

目的：探讨老年继发性慢性肾脏病的病因病机、辨证分型情况,为老年继发性慢性肾脏病分型的统一提供参考,更好地协助临床诊疗。方法：通过对近年来临床医家诊治继发性慢性肾脏病的经验进行总结,归纳老年继发性慢性肾脏病的病因病机及辨证分型规律。结果：老年继发性慢性肾脏病的病机特点为虚实夹杂,本虚以肝、脾、肾亏虚为主,标实以湿、热、瘀、毒为主。虚证常见证型为气阴两虚型、肝肾阴虚型、脾肾气虚型、脾肾阳虚型、阴阳两虚型,实证为水饮型、湿浊型、湿热型、血瘀型、浊毒型。结论：老年继发性慢性肾脏病为虚实夹杂之证,多从气虚、阴虚、阳虚、湿浊、瘀血、毒邪等方面分型论治。

Study on the Causes, Pathogenesis and Types of the Elderly Secondary Chronic Kidney Disease

Objective：To explore the causes, pathogenesis and types of the elderly secondary chronic kidney disease, so as to provide ref erence for the unity of typing the elderly secondary chronic kidney disease, and assist the clinical diagnosis and treatment better. Methods：Doctors＇ experience in diagnosis and treatment of secondary chronic kidney disease in clinic in recent years were reviewed and cau ses and pathogenesis and differentiation typing law of elderly secondary chronic kidney disease were concluded. Results ： The characteris tics of pathogenesis of elderly secondary chronic kidney disease were deficiency mixed with excess. Deficiency in origin was mainly the deficiency of liver, spleen and kidney, while excess in superficiality mainly referred to the dampness, heat, blood stasis, and toxin. Com mon types of deficiency syndrome were deficiency of Qi and Yin, deficiency of liver and kidney, deficiency of spleen and kidney Qi, defi ciency of spleen and kidney Yang, and deficiency of both Yin and Yang. In addition, the excess syndrome types were fluid retention, tur bid dampness, dampness and heat, blood stasis, and turbid toxin. Conclusion：The syndrome of elderly secondary chronic kidney disease was deficiency mixed with excess, and differentiation and treatment should be discussed from the typing of the deficiency of Qi, Yin,or Yang, turbid dampness, blood stasis, or toxin, etc.