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中医学体質治未病による腎臓病多重共病への新戦略

  • role： First author第一作者
  • Affiliation：

    Wangqi Academy, National Institute of TCM Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing 100029, China

  • Introduction：王琦，男，教授，主任医师，研究员，博士生导师，中国工程院院士，国医大师，主要研究方向：中医体质学，E-mail：wangqi710@126.com
WANG Qi,  
  • Affiliation：

    Wangqi Academy, National Institute of TCM Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing 100029, China

WANG Huaiyu

サマリー

多重共病は世界の公衆衛生分野における重要な課題となっており、特に腎臓病患者においては、糖尿病や高血圧などの代謝疾患や心血管疾患と慢性腎臓病が相互作用し、疾患の複雑性と治療の難しさを一層悪化させています。現在の病種ごとに重ねる治療戦略は、多重共病の管理において比較的受動的であり、複雑な多剤併用の問題を引き起こしています。疾病医学の理論的枠組みを突破し、思考の固定観念を打破し、新たな治療戦略を模索することが緊急に求められています。これを踏まえ、本稿では腎蔵象理論と中医学体質治未病の思想を融合させることでこの難題を解決できる可能性を提唱します。治未病は中医学の強みかつ特色であり、中医学体質学は治未病の重要な手段であり、腎蔵象理論は中医学腎臓病学の核心であり、全体観の思想が貫かれています。健康―疾病の全周期内における様々な未病状態を細分化し、「体質土壌論」の指導のもと、様々な偏った体質における疾病臓腑の伝変規律と腎臓病の発症・進展への影響を探求します。これらの規律に基づき、現代腎臓病学の研究成果を有機的に融合し、異なる未病状態やタイプの腎臓病およびその共病モデルに対する同時防治計画をカスタマイズすることで、腎臓病の多重共病問題に効果的に対処できます。

キーワード

多重共病;腎臓病;治未病;中医学体質学

References

  1. [1].
    SKOU ST, MAIR FS, FORTIN M, et al. Multimorbidity[J]. Nat Rev Dis Primers, 2022, 8(1): 48.
  2. [2].
    FAN JN, SUN ZJ, YU CQ, et al. Multimorbidity patterns and association with mortality in 0.5 million Chinese adults[J]. Chin Med J, 2022, 135(6): 648-657.
  3. [3].
    WANG HY, HUANG YM, ZHOU MR, et al. Socioeconomic support, quality of life, and prognosis of frailty among the older adults[J]. Health Care Sci, 2024, 3(2): 101-113.
  4. [4].
    NDUMELE CE, NEELAND IJ, TUTTLE KR, et al. A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American heart association[J]. Circulation, 2023, 148(20): 1636-1664.
  5. [5].
    GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990—2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2020, 395(10225):709-733.
  6. [6].
    WANG LM, XU X, ZHANG M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance[J].JAMA Intern Med, 2023, 183(4): 298-310.
  7. [7].
    WANG HY, DING GH, LIN HB, et al. Influence of doctors′ perception on the diagnostic status of chronic kidney disease: results from 976409 individuals with electronic health records in China[J]. Clin Kidney J, 2021, 14(11): 2428-2436.
  8. [8].
    FOREMAN KJ, MARQUEZ N, DOLGERT A, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories[J]. Lancet, 2018, 392(10159): 2052-2090.
  9. [9].
    CHEN TK, HOENIG MP, NITSCH D, et al. Advances in the management of chronic kidney disease[J]. BMJ, 2023, 383: e074216.
  10. [10].
    李平,李顺民,程庆砾.现代中医肾脏病学[M].北京:中国医药科技出版社, 2021:2-15.
  11. [11].
    王钢,邹燕勤,周恩超.邹云翔实用中医肾病学[M].北京:中国中医药出版社, 2013:54-77.
  12. [12].
    中国中西医结合学会,中华中医药学会,中华医学会.慢性肾衰竭中西医结合诊疗指南[EB/OL]. (2023-05-31)[2025-04-15]. .
  13. [13].
    Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease[J]. Kidney Int, 2024, 105(4S): S117-S314.
  14. [14].
    王琦.中医未病学[M].北京:中国中医药出版社, 2015:3-25.
  15. [15].
    国务院办公厅.国务院办公厅关于印发中国防治慢性病中长期规划(2017—2025年)的通知[EB/OL]. (2017-02-14)[2025-04-15]. .
  16. [16].
    中华人民共和国中央人民政府.中共中央 国务院印发《“健康中国2030”规划纲要》[EB/OL]. (2016-10-25)[2025-04-15]. .
  17. [17].
    American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes:standards of care in diabetes-2024[J]. Diabetes Care, 2024,47(Suppl 1):S20-S42.
  18. [18].
    WHELTON PK, CAREY RM, ARONOW WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American college of cardiology/American heart association task force on clinical practice guidelines[J]. Hypertension, 2018, 71(6):e13-e115.
  19. [19].
    JIA WP, YU R, WANG LM, et al. Prevalence of chronic kidney disease among Chinese adults with diabetes: a nationwide population-based cross-sectional study[J]. Lancet Reg Health West Pac, 2025, 55: 101463.
  20. [20].
    LIANG X, WANG Q, JIANG ZQ, et al. Clinical research linking traditional Chinese medicine constitution types with diseases: a literature review of 1639 observational studies[J]. J Tradit Chin Med, 2020, 40(4):690-702.
  21. [21].
    中华中医药学会.关于发布《老年人中医体质治未病干预指南》等20项中医治未病干预指南的通知[EB/OL]. (2023-03-24)[2025-04-15]. .
  22. [22].
    KRISHNA MT, SUBRAMANIAN A, ADDERLEY NJ, et al. Allergic diseases and long-term risk of autoimmune disorders: longitudinal cohort study and cluster analysis[J]. Eur Respir J, 2019, 54(5): 1900476.
  23. [23].
    MARTUCCI MA, DRESKIN SC. Immunologic similarities between selected autoimmune diseases and peanut allergy: possible new therapeutic approaches[J]. Curr Allergy Asthma Rep, 2011, 11(4): 334-339.
  24. [24].
    申荣旻.中药过敏康调体治疗过敏性鼻炎机制研究[D].北京:北京中医药大学, 2016.
  25. [25].
    孙淑娴.过敏体质Th17细胞分化相关分子表达及过敏康调体干预机制研究[D].北京:北京中医药大学, 2016.
  26. [26].
    王琦,骆庆峰,赵厚薇.过敏康Ⅱ号胶囊治疗男性免疫性不育42例临床观察[J].中医杂志, 2005, 46(2): 119-121.
  27. [27].
    骆庆峰,王琦,牛欣.过敏康Ⅱ号胶囊对NIH雄性小鼠血清抗精子抗体的影响[J].北京中医药大学学报, 2003, 26(3): 41-43.
  28. [28].
    Kidney Disease: Improving Global Outcomes (KDIGO) IgAN and IgAV Work Group, ROVIN BH, BARRATT J, et al. KDIGO 2025 clinical practice guideline for the management of immunoglobulin A nephropathy (IgAN) and immunoglobulin A vasculitis (IgAV)[J]. Kidney Int, 2025, 108(4): S1-S71.
  29. [29].
    王琦.王琦治疗62种疑难病[M].北京:中国中医药出版社, 2012: 49-52.

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