从一气周流探析心血管-肾脏-代谢综合征的病机与施治

Analysis of the Pathogenesis and Treatment of Cardiovascular-Kidney-Metabolic Syndrome from the Perspective of Circular Flow of Original Qi

摘要:

一气周流的核心内涵为“中焦土气斡旋，左轮水木升发，右轮火金敛降”的阴阳气机升降格局。心血管-肾脏-代谢综合征（CKMS） 的核心病机为中焦脾胃运化失司，土气枢转无力，致一气周流窒碍，肝、心、肺、肾四脏功能失调，进而滋生痰浊、湿阻、血瘀等病理产物。脾胃失运为病机始动因素，肝失疏泄是病情进展的重要推手，心阳不足、肾失封藏为核心根本，肺失宣降则为协同影响因素。基于此，确立健运中焦、疏调肝木、温通心阳、补益肾元、宣降肺金的治疗原则，突出整体调节、辨证论治核心，通过复归一气周流的气运，达成CKMS的有效施治。

Abstract:

Abstract：The core connotation of circular flow of original qi refers to the yin-yang pattern of qi movement：the mediation of "earth qi in the middle energizer，the ascending and dispersing of wood and water on the left pivot，and the descending and astringing of fire and metal on the right pivot." The core pathogenesis of cardiovascular-kidneymetabolic syndrome （CKMS） consists in the dysfunction of transportation and transformation of the spleen and stomach， and the weakened pivot function of earth qi，which results in the obstruction of circular flow of original qi，dysfunction of the liver，heart，lung，and kidney，and further induces pathological changes such as phlegm turbidity，dampness stagnation， and blood stasis. Dysfunction of the spleen and stomach is the initiating pathogenic factor； failure of the liver in free coursing is an important driver of disease progression； insufficient heart yang and impaired storage and consolidation of the kidney are the fundamental root causes；and disordered diffusion and descent of the lung acts as a synergistic influencing factor. On this basis， the therapeutic principles are formulated， including strengthening and regulating the middle energizer，soothing liver qi，warming and unblocking heart yang，tonifying kidney essence，and regulating pulmonary diffusion and descent. It emphasizes holistic regulation and treatment based on syndrome differentiation. Restoring the normal operation of circular flow of original qi can achieve effective treatment of CKMS.