慢性肾衰竭(CRF)患者的心血管疾病(CVD)是影响CRF 患者预后的主要因素,临床上以左心室肥厚、心肌间质纤维化、心脏功能障碍、缺血性心脏病、瓣膜病变及血管病变为主。 其中左心室肥厚在CRF 患者中的发生率高达40% ～60%,其病死率高出一般人群10 ～20 倍^[1]。 CVD 已经成为CRF 患者寿命明显缩短的最重要原因。 因此,加强对CVD 的认识对改善CRF 患者预后有着重要意义。 笔者结合多年中医临床经验,认为本病病机为本虚标实之证,本虚以心肾不足、气阴两虚为主,标实以痰瘀互结为主;提出以肾治心,心肾同治的学术观点,临床辩证分为交通心肾法、温阳利水法、养血益精法、补肾活血法、养阴清热法、温补心肾法六法。

Cardiovascular disease (CVD) is the main factor that affects the prognosis of patients with chronic renal failure (CRF), which mainly includes left ventricular hypertrophy, myocardial interstitial fibrosis, cardiac dysfunction, ischemic heart disease, valve disorder, and vasculopathy. The incidence of left ventricular hypertrophy in CRF patients is 40%-60%, whose fatality rate is 10-20 times that of the general population. CVD has already become the most important cause for the shortening of lifespan in CRF patients. Therefore, it is of great significance to reinforce the knowledge of CVD for improving the prognosis of patients with CRF. By summarizing his many years of clinical experience, and from the point of view of the traditional Chinese medicine, the writer considered that the pathogenesis of this disease is deficiency in origin and enrichment in symptom. The deficiency in origin is mainly deficiency in heart and kidney,deficiency of Qi and Yin, while the enrichment in symptom is mainly Tanyuhujie syndrome. So the treatment should be carried out on both the heart and the kidney,which in clinical dialectical therapy is divided into six aspects: coordinating heart and kidney method, enhancing Yang to promote diuresis method, nourishing blood and Jing method, invigorating kidney and promoting blood circulation method, Yangyinqingre method, and Wenbuxinshen method.