基于“中气不足，溲便为之变”探讨再发性尿路感染辨治思路

高梦琦; 张传龙; 庞博; 王佳喆; 韩佳童; 刘世巍

doi:10.3969/j.issn.1006-2157.2023.08.015

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基于“中气不足，溲便为之变”探讨再发性尿路感染辨治思路

临床研究 | 更新时间：2023-09-08

- 基于“中气不足，溲便为之变”探讨再发性尿路感染辨治思路
- Discussion on the differentiation treatment of recurrent urinary tract infections based on "Zhongqi Deficiency Leading to Urine and Defecation Change"
- 北京中医药大学学报 2023年46卷第8期页码：1161-1165
- 作者机构：
  
  1.中国中医科学院望京医院　北京　100102
  2.中国中医科学院广安门医院
  3.中国中医科学院广安门医院国际医疗部
  4.北京中医药大学
- 作者简介：
  
  高梦琦，男，在读博士生
  # 刘世巍，女，博士，教授，主任医师，博士生导师，主要研究方向：肾脏病及内分泌系统疾病的治疗，E-mail：liushiwei1977@126.com
- 基金信息：
  
  国家自然科学基金项目(82074407);北京市自然科学基金项目(7212196);中国中医科学院科技创新工程重大攻关项目(CI2021A01204);第五批全国中医临床优秀人才研修项目(国中医药办人教函〔2021〕271号)
- DOI：10.3969/j.issn.1006-2157.2023.08.015
  中图分类号： R256.5
- 纸质出版日期：2023-08-30，
  
  网络出版日期：2023-07-04，
  
  收稿日期：2023-01-30，
- 稿件说明：
移动端阅览
高梦琦, 张传龙, 庞博, 等. 基于“中气不足，溲便为之变”探讨再发性尿路感染辨治思路[J]. 北京中医药大学学报, 2023,46(8):1161-1165.

GAO Mengqi, ZHANG Chuanlong, PANG Bo, et al. Discussion on the differentiation treatment of recurrent urinary tract infections based on "Zhongqi Deficiency Leading to Urine and Defecation Change"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(8):1161-1165.
高梦琦, 张传龙, 庞博, 等. 基于“中气不足，溲便为之变”探讨再发性尿路感染辨治思路[J]. 北京中医药大学学报, 2023,46(8):1161-1165. DOI： 10.3969/j.issn.1006-2157.2023.08.015.

GAO Mengqi, ZHANG Chuanlong, PANG Bo, et al. Discussion on the differentiation treatment of recurrent urinary tract infections based on "Zhongqi Deficiency Leading to Urine and Defecation Change"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(8):1161-1165. DOI： 10.3969/j.issn.1006-2157.2023.08.015.

摘要

再发性尿路感染(RUTI)是临床常见的感染性疾病，多见于老年、绝经后妇女及免疫缺陷人群，以反复发作、缠绵难愈为特点，是临床治疗难题。本文基于《黄帝内经》“中气不足，溲便为之变”理论，结合西医学病理机制，探讨RUTI的核心病机与辨治思路。中气不足、湿浊伏邪、流连阴窍是RUTI的核心病机；中气不足，脾失谏议为发病基础；脾虚水湿不运，湿浊客于阴窍为发病诱因；中气不足，无力祛邪，湿浊伏于下焦，流连不去，成为伏邪，伺机而发，是RUTI反复发作之根源。治疗方面，重视患病人群特点，以中气为重，调平扶正贯穿始终。发作期攻补兼施，以调平为贵；缓解期调养中气，以扶正为要。以期充实RUTI从中气论治的理论依据，为其临床研究和治疗提供新的思路。

Abstract

Recurrent urinary tract infection (RUTI) is a common clinical condition mostly seen in the elderly

post-menopausal women

and people with immunodeficiency. It is characterized by its intractable nature and a high recurrence rate

making it a clinical treatment challenge. We discuss the core pathogenesis and treatment of RUTI based on the theory of "Zhongqi Deficiency Leading to Urine and Defecation Change" in the

Yellow Emperor

’

s Classic of Internal Medicine

and the pathological mechanism of modern medicine. On this basis

it is proposed that Zhongqi deficiency

dampness and turbidity

and lingering in the yin orifice are the core pathogenic mechanisms of RUTI. Zhongqi deficiency and loss of activity of the spleen are the basis of the disease. Spleen deficiency

water dampness

and dampness and turbidity in the yin orifice induce RUTI. Zhongqi deficiency impedes the dispelling of evil

so the dampness lies in the lower jiao and lingers on

becoming a vague evil

waiting for an opportunity to flare up

which is the root cause of recurrent RUTI. In terms of treatment

we attach importance to the characteristics of the patient and focus on the Zhongqi

and harmonize the middle qi throughout. During the attacking period

both attack and tonification are applied

and during the remission period

the middle energy is nourished and righteousness is supported. The aim is to enrich the theoretical basis of the treatment of RUTI from the Zhongqi and to provide new ideas for clinical research and treatment.

关键词

再发性尿路感染中气不足免疫监视调平扶正

Keywords

recurrent urinary tract infectiondeficiency of Zhongqiimmune surveillancekeeping a dynamic balance and strengthening healthy qi

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