【摘要】 “血瘀”作为慢性肾脏病（CKD）的核心病理状态，贯穿疾病始终，是影响其预后的关键因素。本文立足于黄元御《四圣心源·劳伤解》学术思想，结合现代医学理论与团队临证经验，系统探讨了CKD“血瘀”状态的辨治体系。“血瘀”状态可见于CKD的各个证型之中，以血虚挟瘀、土湿木郁、肾虚血瘀三种证型最为典型：血虚挟瘀证方选桂枝丹皮桃仁汤合大补元煎加减，重在补益气血、活血化瘀；土湿木郁证方选紫苏姜苓汤加柴胡、川牛膝加减，旨在理气解郁、温脾祛湿、活血化瘀；肾虚血瘀证方选破瘀汤、益气养阴桃红四物汤、二仙汤等，注重补肾填精、调和阴阳、活血化瘀。构建以“调和脏腑、活血化瘀”为核心的分型论治框架，凸显黄元御劳伤理论在CKD诊治中的指导价值，为中医临证辨治CKD“血瘀”状态提供了理论依据与实践参考，也为深化经典理论与现代临床结合研究提供了方向。更多还原

【Abstract】 “Blood stasis” is the core pathological state of chronic kidney disease(CKD),which runs through the whole course of the disease and is a key factor affecting its prognosis. Based on HUANG Yuanyu’s academic thoughts in Consumptive Injury in Four Sages’ Heart Source,combined with modern medical knowledge and the clinical experience of our team,this paper systematically explores the syndrome differentiation and treatment system of the “blood stasis” state in CKD. The “blood stasis” state can be seen in various syndrome types of CKD,with three syndrome types being the most typical:blood deficiency with stasis,dampness in the spleen and stagnation of the liver qi,and kidney deficiency with blood stasis. For the syndrome of blood deficiency with stasis,Guizhi Danpi Taoren Decoction（桂枝丹皮桃仁汤） combined with Dabuyuan Decoction（大补元煎） should be selected,focusing on tonifying qi and replenishing blood,promoting blood circulation to resolve stasis;for the syndrome of dampness in the spleen and stagnation of the liver qi,Zisu Jiangling Decoction（紫苏姜苓汤） with the addition of Chaihu(Bupleuri Radix) and Chuanniuxi(Cyathular Radix) should be selected,aiming at regulating qi and relieving depression,warming the spleen and removing dampness,and promoting blood circulation to remove stasis;for the syndrome of kidney deficiency with blood stasis,Poyu Decoction（破瘀汤）,Yiqi Yangyin Taohong Siwu Decoction（益气养阴桃红四物汤）,Erxian Decoction（二仙汤）,etc. are selected,emphasizing on tonifying the kidney and supplementing essence,regulating yin and yang,and promoting blood circulation to remove stasis. A framework of syndrome-differentiated treatment centered on “regulating Zang-Fu viscera and promoting blood circulation to remove stasis” is constructed,highlighting the guiding value of HUANG Yuanyu’s theory of consumptive injury in the diagnosis and treatment of CKD. It provides a theoretical basis and practical reference for the clinical syndrome differentiation and treatment of the “blood stasis” state in CKD in traditional Chinese medicine,and also provides a direction for in-depth research on the combination of classic theories and modern clinical practice.更多还原