陆曼玉 王圣治

【摘要】 慢性肾脏病以其起病隐匿，预后不佳的特点，严重危害人类的健康，因此早期预防，延缓进展，减少并发症显得尤为重要，这与中医特色“治未病”思想极为相似。此外，中医拥有独特的大局观-整体观念，强调治疗时应“因时、因地、因人制宜”，以二者为基本理念构建的中医慢病管理体系，现已应用于临床当中，有效地改善了患者的临床症状及部分检验指标。中医慢病管理的具体实施方案中包含中医内、外治法，中医内治法包括中药方剂疗法、中医食疗法、情志疗法等;中医外治法包括穴位贴敷疗法、灌肠疗法、运动疗法、针灸疗法以及耳穴压豆疗法等。

【关键词】 慢性肾脏病 中医 慢病管理 内治法 外治法

Study on the Application of Chronic Disease Management in Chronic Kidney Disease/LU Manyu， WANG Shengzhi. //Medical Innovation of China， 2021， 18（35）： -184

[Abstract] Chronic kidney disease is a serious hazard to human health due to its insidious onset and poor prognosis， so it is particularly important to prevent early， delay progress and reduce complications， which is very similar to the Traditional Chinese Medicine （TCM） “treating pre-disease” thought. In addition， TCM has a unique holistic view， emphasizing that treatment should be tailored to “applying proper therapeutic measure in line with season， local conditions and individuality”. The TCM chronic disease management system based on the two basic concepts has been applied in clinical practice， which has effectively improved the clinical symptoms and some laboratory indicators of patients. The specific implementation plan of chronic disease management of TCM includes internal and external TCM treatment， which includes TCM prescription therapy， TCM food therapy， emotional therapy， etc. The external treatment of traditional Chinese medicine includes acupoint sticking therapy， enema therapy， exercise therapy， acupuncture and moxibustion therapy and ear point pressing therapy.

[Key words] Chronic kidney disease Traditional Chinese medicine Chronic disease management Internal treatment External treatment

First-author’s address： Liaoning University of Traditional Chinese Medicine， Shenyang 110032， China

doi：10.3969/j.issn.1674-4985.2021.35.044

慢性腎脏病（CKD）是多种原因引起的表现为肾脏结构和功能异常的疾病，在临床上较为常见，对人类生命健康造成重大影响[1]。我国18岁以上人群慢性肾脏病发病率较高[2]，因此加强慢性肾脏病的管理如早期防治，延缓进展，减少并发症，降低死亡率等，才能真正达到延缓和逆转慢性肾脏病进展的目标，这与中医“治未病”思想不谋而合，加之中医独有的整体观念，特色辨证理论以及丰富的养生保健方法，慢性肾脏病管理中医介入就显得尤为必要。

1 中医特色慢病管理在慢性肾脏病应用的国内现状研究

陈彩凤等[3]开展的中医慢病管理对慢性肾脏病患者生活质量的影响研究显示，57例CKD 3、4期患者在对照组基础上应用中医慢病管理后，患者的肾功能有所改善，生活质量明显提高，表明中医慢病管理可提高临床疗效，值得大范围推广。……