慢性肾衰竭（CRF）核心病机为脾肾两虚、湿浊瘀毒互结，形成“精亏-络损-浊毒”的恶性循环。文章基于“肾藏精泄浊”理论，系统阐释固肾泄浊法论治CRF的理论依据及临床实践经验。固肾泄浊法以“固肾培本，分消浊毒”为纲，通过填精固摄恢复脾肾气化枢纽，通络活血改善肾络瘀阻，并分消三焦湿浊、瘀浊、毒浊，打破“精微漏泄－浊毒蓄积—络脉损伤”病理过程。唐阁主任基于此创立固肾泄浊方，临床观察表明该方治疗CRF患者疗效确切。固肾泄浊方组方注重脾肾互根、寒温相济、升降相因，动态调整固肾与泄浊权重，契合CRF不同分期病机演变。固肾泄浊法融合藏象学说、络病理论及三焦气化论，以“补泻兼施、藏泄并调”实现标本同治，为CRF中医药治疗提供新思路。

       The core pathological mechanism of chronic renal failure（CRF）involves deficiency of the spleen and kidney，intertwined with dampness，turbidity，blood stasis and toxins，forming a vicious cycle of “essence deficiency-collateral damage-turbid toxin accumulation” Based on the theory of “The kidney stores essence and reduces turbidity”，this article systematically elucidates the theoretical foundation and clinical application of  reinforcing the kidney and  reducing turbidity method for treating CRF．This method，guided by the principles of “securing the kidney to strengthen the root，and resolving turbid toxins”，aims to replenish essence and consolidate the kidney to restore the pivotal qi transformation functions of the spleen and kidney，to unblock collaterals and circulate blood to ameliorate renal collateral stasis，to resolve damp-turbidity，stasis-turbidity，and toxin-turbidity from the Sanjiao．This strategy breaks the pathological progression of “leakage of essence-accumulation of turbid toxins-damage to collaterals”．Professor Tang Ge formulate this Reinforcing the Kidney and Reducing Turbidity Formula（固肾泄浊方，Gushen Xiezhuo Fang）based on this approach．Clinical observations confirmed its significant efficacy in CRF patients．The formula focuses on the interdependence of the spleen and kidney，balance of warm and cool properties，and harmony of ascending and descending actions．It dynamically adjusts the therapeutic focus between kidney-securing and turbidity-reducing to align with the evolving pathogenesis across different CRF stages．Integrating theories of visceral manifestation（Zangxiang），collateral disease，and Sanjiao qi transformation，reinforcing the kidney and  reducing turbidity method achieves simultaneous treatment of  root and branch through “simultaneous supplementation and drainage，concurrent storing and discharging”．This approach offers a novel perspective for the traditional Chinese medicine treatment of CRF．

目的 探讨宣清导浊汤加减方联合血液透析治疗对老年慢性肾衰竭（CRF）患者肾功能、微炎症状态和毒素清除率的影响。方法 回顾性选取2019年10月—2022年10月我院收治的82例老年CRF患者,将其根据治疗方法分为联合组与单一组,每组41例。单一组仅采取血液透析治疗,联合组联合宣清导浊汤加减方治疗,对比两组患者治疗前后中医证候积分、毒素清除率、炎症因子变化。结果 治疗后,两组患者口淡不渴、肢体麻木、腰膝酸软、倦怠乏力、食少纳呆以及面色晦暗相关中医证候积分均降低,且联合组低于单一组（P<0.05）;治疗后两组患者血肌酐、尿素氮、血β₂-微球蛋白均降低,联合组低于单一组（P<0.05）;治疗后两组患者白细胞介素-6、C-反应蛋白、肿瘤坏死因子-α炎性因子水平明显降低,且联合组更低（P<0.05）。两组在治疗期间均无不良反应。结论 宣清导浊汤加减方联合血液透析治疗老年CRF患者效果较佳,可通过降低机体炎症因子表达水平、提高毒素清除率来改善患者临床症状,且不会增加不良反应。

Objective To explore the effect of Xuanqing Daozhuo Decoction modified formula combined with hemodialysis treatment on renal function,micro inflammatory status,and toxin clearance rate in elderly patients with chronic renal failure（CRF）．Methods Retrospectively,82 elderly CRF patients admitted to our hospital from October 2019 to October 2022 were selected and divided into a combination group and a single group according to the treatment methods,with 41 cases in each group． The single group was treated with hemodialysis only,and the combined group was treated with Xuanqing Daozhuo Decoction modified formula additionally．The changes of TCM syndrome scores,toxin clearance rate and inflammatory factors before and after treatment were compared between the two groups．Results After treatment,the scores of TCM syndroms including tasteless mouth and no thirst,numbness of limbs,soreness and weakness of waist and knee,fatigue,poor appetite and sluggish stomach were all decreased in 2 groups,and those in combined group were lower（P<0.05）．After treatment,serum creatinine,blood urea nitrogen and β₂-microglobulin were decreased in 2 groups,and those in combined group were lower（P<0.05）．After treatment,the levels of interleukin-6,C-reactive protein and tumor necrosis factor-α inflammatory factors were significantly decreased in 2 groups,which were lower in combination group（P<0.05）．The two groups had no adverse effects during the treatment period．Conclusions Xuanqing Daozhuo Decoction modified formula and hemodialysis can improve the clinical symptoms of elderly patients with CRF,reduce the expression level of inflammatory factors in patients,and increase the clearance rate of toxins in patients,and does not increase the adverse effects．

目的 分析慢性肾衰竭患者接受肾衰康方治疗对其血清微炎症状态的影响及肾功能的保护作用。方法 将2020年1月—2020年12月作为研究时间段,选取期间广东祈福医院接诊的50例慢性肾衰竭患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入25例)、观察组(加用肾衰康方治疗,纳入25例),对组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标展开分析。结果 组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗前无明显差异,P>0.05;观察组中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗后优于对照组,P<0.05。结论 肾衰康方对改善慢性肾衰竭患者血清微炎症状态、氧化应激水平、临床症状均有较好效果,且能保护肾功能,值得推广。

Objective To analyze the effect of Shenshuaikang decoction on serum microinflammation and renal function in patients with chronic renal failure. Methods From January 2020 to December 2020, 50 patients with chronic renal failure treated by Clifford Hospital were selected, and the random number table method was used for grouping. All cases were divided into control group (n=25) and observation group (n=25). The TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index were analyzed. Results There were no significant differences in TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index between the two groups before treatment, P>0.05; the TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index of the observation group were better than those of the control group after treatment, P<0.05. Conclusion Shenshuaikang decoction has good effect on improving serum microinflammation, oxidative stress level and clinical symptoms of patients with chronic renal failure, and also can protect renal function, which is worthy of promotion.