Application of the “Elimination and Tonification Combined” Theory in Gouty Nephropathy

痛风性肾病是痛风日久，体内尿酸生成过多或排出减少引起的慢性肾脏疾病，其病程长，致死率高。现代西医治疗以调节尿酸盐排出，保护肾功能为主，但部分患者存在病情反复且用药效果不达预期的情况。中医药治疗痛风性肾病可明显改善其症状，控制疾病进展。本病病机本虚标实，虚实夹杂贯穿疾病始终，后期“穷必及肾”加重患者病情，影响患者寿命。本文通过论述“分消走泄”、“阳化气，阴成形”、“开鬼门，洁净府，去宛陈莝”和“命门学说”理论在痛风性肾病中的应用，进一步证明“消补兼施”法在该病的治疗中具有重要的临床意义。Gout-induced nephropathy is a chronic kidney disease caused by prolonged gout, where excessive uric acid production or reduced excretion occurs in the body. It is a long-term disease with a high mortality rate. Modern Western medicine mainly focuses on regulating uric acid excretion and protecting renal function. However, some patients experience recurrence of the condition and the therapeutic effects of medication do not meet expectations. Traditional Chinese medicine treatment for gout-induced nephropathy can significantly improve symptoms and control disease progression. The pathogenesis of this disease involves both deficiency and excess, with deficiency and excess alternating throughout the disease course. In the later stage, “extreme deficiency may reach the kidney” aggravates the patient’s condition and affects their lifespan. This article discusses the application of theories such as “separation and elimination of pathogenic factors”, “transforming qi and generating body fluids”, “opening the ghost door, purifying the bowels, and eliminating the accumulated turbid matter”, and “the theory of the kidney yang” in gout-induced nephropathy. This further proves that the “combination of elimination and supplementation” method has significant clinical significance in the treatment of this disease.