通讯作者: 孟立锋, mlf428@126.com

DOI：10.12201/bmr.202603.00100

Exploring Traditional Chinese Medicine Treatment Principles for Chronic Kidney Disease Based on Age Stratification

• 摘要：慢性肾脏病（Chronic Kidney Disease,CKD)起病隐匿、病程迁延、预后不良。CKD可见于各个年龄阶段人群，其核心病机是“肾虚湿瘀”，以“益肾清利、和络泄浊”为治则1，由于不同年龄阶段人群的肾脏生理病理特点及病理演变规律存在差异，因此不同年龄阶段CKD患者中医治则不同。中医经典理论认为人体肾气随年龄增长呈现“肾气盛—肾气平均—肾气衰”的规律变化，现代医学研究认为人体肾小球滤过率随增龄呈进行性减退，肾小管重吸收和分泌功能亦呈渐进性弱化，可见年龄是CKD中医药“个体化治疗”的关键影响因素。《素问?示从容论》载：“夫年长则求之于腑，年少则求之于经，年壮则求之于脏 。”以此经典理论为核心框架，结合不同年龄阶段CKD患者的肾脏特点，构建基于“年龄分层”的“个体化治疗”策略：老年CKD患者以“从腑治肾”为核心治则；小儿CKD患者以“从经治肾”为核心治则；壮年CKD患者以“从脏治肾”为核心治则。本文系统阐述上述治则的理论溯源与实践逻辑，以期为CKD的中医药防治提供创新性诊疗思路与方法学支撑。

  关键词： 年龄分层; 慢性肾脏病; 中医药治则; 个体化治疗；

   

  Abstract: Chronic Kidney Disease (CKD) is characterized by its insidious onset, prolonged course, and poor prognosis. It can occur across all age groups, but its core pathogenesis lies in kidney deficiency and dampness-stasis. The treatment principle is tonifying the kidneys, clearing dampness, harmonizing collaterals, and expelling turbidity 1. However, due to differences in renal physiological and pathological characteristics and progression patterns among different age groups, the treatment principles of Traditional Chinese Medicine (TCM) for CKD also vary accordingly. Classical TCM theory posits that renal energy follows a developmental pattern of prosperity—balance—decline with aging. Modern medical research indicates that glomerular filtration rate progressively declines with age, while tubular reabsorption and secretion functions also gradually weaken. Thus, age emerges as a critical factor influencing the individualized treatment of CKD in TCM. The Suwen·On the Principle of Treatment states: For the elderly, treatment should target the internal organs; for the young, it should target the collaterals; and for the vigorous, it should target the organs. Building upon this theoretical framework and considering the physiological and pathological characteristics of CKD patients across different age groups, an age-stratified individualized treatment strategy is proposed:For elderly CKD patients, the core principle is treating the kidneys through the internal organs. For middle-aged CKD patients, the core principle is treating the kidneys through the organs. For pediatric CKD patients, the core principle is treating the kidneys through the collaterals. This paper systematically elaborates on the theoretical origins and practical logic of these treatment principles, aiming to provide innovative diagnostic and therapeutic approaches and methodological support for the TCM prevention and treatment of CKD.

  Key words: Age stratification; chronic kidney disease; principles of traditional Chinese medicine; individualized treatment

  提交时间：2026-03-23

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 郭慧芳, 沈沛成. 慢性肾脏病中医非药物疗法研究概述. 2024. doi: 10.12201/bmr.202409.00054

  段嘉敏, 蔡旭东. 基于“亢害承制”理论探讨巨噬细胞极化在慢性肾脏病肾纤维化发展中的作用. 2024. doi: 10.12201/bmr.202407.00027

  贾易杰, 王永吉. 基于《中华医典》中医治疗小儿腹泻用药规律探讨. 2026. doi: 10.12201/bmr.202605.00090

  徐慧颖, 王向明. 功能整体性教学在慢性肾脏病临床带教中的应用. 2024. doi: 10.12201/bmr.202406.00016

  李偏, 叶涛, 申娜▲. 高尿酸血症对慢性肾脏病影响的研究进展. 2025. doi: 10.12201/bmr.202503.00045

  胡静, 王河宝. 慢性乙型肝炎的中医发病机理探究. 2025. doi: 10.12201/bmr.202508.00016

  施靖瑜, 王少扬. 中医药调控信号通路协同治疗慢性乙型肝炎与2型糖尿病的研究进展. 2026. doi: 10.12201/bmr.202602.00018

  曹立群, 陈红波. 新型生物标志物在慢性肾脏病早期诊断中的价值. 2025. doi: 10.12201/bmr.202508.00003

  谢文佳, 倪佳宁, 周舒燕, 章婷婷, 蔡旭东. 中西结合慢性肾脏病管理对CKD3-5期非透析患者临床应用观察. 2024. doi: 10.12201/bmr.202409.00065

  梁乐然, 阎誉豪, 唐跃豪, 练洢彤, 徐倩, 杨猛, 伍家亨, 陈振虎, 刘秀峰. 基于知识图谱和大语言模型的中医药治疗帕金森病智能问答研究. 2026. doi: 10.12201/bmr.202604.00033

• 序号	提交日期	编号	操作
  1	2026-01-21	10.12201/bmr.202603.00100V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论