河南中医2025，Vol.45Issue(11)：1767-1774,8.DOI:10.16367/j.issn.1003-5028.2025.11.0285
中医药治疗慢性肾脏病相关性瘙痒研究进展
Research Progress on Traditional Chinese Medicine in Treating Chronic Kidney Disease-Associated Pruritus
摘要
Abstract
The pathogenesis of chronic kidney disease-associated pruritus(CKD-aP)in TCM is characterized by deficiency in root cau-ses and excess in manifestations.The root causes'deficiency is attributed to spleen-kidney deficiency,as well as qi and blood insuffi-ciency,while the excess manifestations arise from the internal accumulation of pathogenic factors such as wind,dampness,blood stasis,and toxins,etc.Treatment should follow the principle of"addressing the root causes of disease,"focusing on tonifying the spleen and kidney to consolidate the root.This is supplemented by the principle of"treating the manifestations in acute cases,"aimed at elimina-ting pathogens and relieving pruritus to address the symptoms.The approach emphasizes simultaneous treatment of both root causes and manifestations,strengthening healthy qi and resolving toxins.Clinically,modified classical formulas such as combination of half Cinna-mon Twig Decoction and half Ephedra Decoction,Anti-Allergy Decoction,Wind-Dispersing Powder,are commonly used,and often com-bined with classic drug pairs such as Jingjie(Herba Schizonepetae)-Fangfeng(Radix Saposhnikoviae),Baixianpi(Cortex Dictamni)-Difuzi(Fructus Kochiae),Kushen(Radix Sophorae Flavescentis)-Shechuangzi(Fructus Cnidii),Dahuangtan(Carbonized Rhubarb)-Puhuangtan(Carbonized Typha Pollen),etc.When integrated with external TCM therapies,significant therapeutic effects are often a-chieved.However,current research still faces the following shortcomings:(1)Insufficient objectivity in syndrome differentiation:Exist-ing syndrome classifications(e.g.,dampness-heat stagnation,blood deficiency with wind-dryness)primarily rely on subjective symptom descriptions,lacking objective quantitative indicators such as metabolomic or imaging data,resulting in poor comparability of efficacy e-valuations.(2)Limited depth in mechanism research:The action targets of most Chinese medicinal formulas remain unclear,and exist-ing animal models struggle to fully replicate the complex pathological environment of CKD-aP(e.g.,secondary hyperparathyroidism).Furthermore,the application of external therapies like acupuncture and enema is often based on experiences,with a lack of evidence-based standards regarding dosage,frequency,and treatment course.(3)Delayed interdisciplinary integration:Standardized pathways for the synergistic application of TCM with modern technologies like hemodialysis and molecular imaging,etc.have not been established.(4)Low level of evidence-based medical evidence:There is a lack of high-quality research involving large-sample,multi-center,ran-domized controlled trials.Therefore,future research should focus on the following three aspects:First,deepening mechanistic explora-tion:Utilizing organoids and 3D skin models to simulate the in vivo microenvironment of CKD-aP,in order to elucidate the multi-target and multi-pathway mechanisms of Chinese medicinal formulas.Secondary,optimizing clinical protocols:Conducting stepped clinical tri-als of integrated Chinese and Western medicine treatments to explore the optimal regimen for reducing toxicity and enhancing efficacy.Thirdly,constructing a proper evaluation system:Developing internationally recognized TCM efficacy evaluation standards for CKD-aP,establishing a correlated rating model that integrates itch intensity,renal function indicators,and psychological scores,in order to pro-mote the effective translation of research findings into clinical practice.关键词
慢性肾脏病相关性瘙痒/中医药/桂枝麻黄各半汤/过敏煎/消风散/荆芥-防风/白鲜皮-地肤子/苦参-蛇床子/大黄炭-蒲黄炭/中医外治法/药对分类
中医学引用本文复制引用
乔佳,林燕..中医药治疗慢性肾脏病相关性瘙痒研究进展[J].河南中医,2025,45(11):1767-1774,8.基金项目
国家自然科学基金面上项目(81373609) （81373609）
国家中医药管理局曹式丽全国名老中医药专家传承工作室建设项目{国中医药人教函[2012]149号} （）
国家中医药管理局第四批全国中医临床优秀人才研修项目{国中医药人教发[2017]124号} （）
天津市名中医林燕传承工作室建设项目(tjmzy2404) （tjmzy2404）
