魏丽凤 王琳

摘要 中医外治理论丰富，研究广泛，治疗方式多样，因其效、验、便、廉等诸多优点已向内外妇儿等多学科领域延伸与推广。因其毒性小，适应证广泛，不经肾脏排泄，避免内服药物对肾脏的影响，故在治疗一些常见肾病中具有显著优势。现从中医外治的溯源与发展、作用机制与特点等方面进行梳理，尤其是在慢性肾脏病中的应用现状进行系统综述，以期促进中医外治法在临床中的推广应用，尤其在肾病治疗中的广泛运用。

关键词 中医外治;慢性肾脏病;方法;疗效;适应证;优势;应用;综述

Abstract Traditional Chinese medicine（TCM）has a rich theory of external treatment，extensive research，and diverse treatment methods.It has been extended and promoted to multi-disciplines such as internal medicine，external medicine，gynecology and pediatrics because of its advantages such as efficacy，effectiveness，convenience and low cost.Because of its low toxicity，extensive indications，excretion without kidneys，and avoiding the effects of oral administration on the kidneys，it has significant advantages in the treatment of some common kidney diseases.This paper sorts out the traceability，development，mechanism and characteristics of TCM external treatment，and especially and systematically reviews its application status in chronic kidney disease，in order to promote the application of TCM external treatment in clinic，especially its wide application in the treatment of nephropathy.

Key Words External treatment of traditional Chinese medicine; Chronic kidney disease; Methods; Efficacy; Indications; Advantages; Application; Review

中图分类号：R242;R692文献标识码：Adoi：10.3969/j.issn.1673-7202.2019.08.062

中醫外治方法历史悠久，内容丰富，从理论到实践不断探索与完善，历经千年的长期临证经验总结，逐渐具备其鲜明独立而特有的治疗技术。其中外治方药从简到繁，治疗方法亦从体外敷贴拓展到熨、贬、灸等诸多方法，中医外治不断从临床经验积累到理论升华，逐渐形成了较为完善的中医外治理论体系[1]。传统中医外治方法与时俱进，融合现代科学技术，利用电、光、声、磁、射线等更新出离子导入、埋药线、封闭等新型外治方法，为中医外治学科增添了新内容。外治技术突破传统的有限领域，积极向当今内科、外科、妇科、儿科等多学科领域延伸[2]。受到现代科学技术水平影响，中医外治借助经皮给药途径，将药物由皮肤吸收进入血液循环系统，发挥其内病外治，靶向治疗的作用，避免了药物经过胃肠道破坏、肝脏分解等首过效应，同时还能降低药物毒性和不良反应[3-5]，因其效、验、便、廉，毒性小，适应证广，避免内服药物对肾脏的不良效应，故在治疗一些常见肾病中亦取得了显著的疗效，前景可观[6-14]。……