肾主水，为先天之本，对于体内津液的运行输布具有重要作用，且肾与水腑膀胱互为表里，通过冲脉与“水谷之海” 的胃有经络上的联系，故肾在痰的生成中起着关键作用。陈博来教授认为，肾虚痰阻型腰痛为本虚标实之证，“痰阻”为其 标，“肾虚”为其本，临床以腰骶钝痛、痛处固定、腰部僵硬、肢体麻木或偏枯为主要特点，兼见腰膝酸软、喜按喜揉等表 现。肾虚痰阻型腰痛的治疗可基于“肾为生痰之本”，以补肾祛痰为法，拟定理痰汤 （主要组成药物为芡实、半夏、黑芝麻、 柏子仁、白芍、陈皮、茯苓等） 为基础方，针对不同兼症辅以健脾、宣肺等药进行加减治疗。其辨治思路可为临床中医治疗 腰痛提供参考。

The kidney governs water and is the congenital foundation. The kidney plays an important role in the transportation and distribution of body fluid，has the interior-exterior relationship with the water fu-organ bladder， and has the meridian connection with the stomach，the reservoir of water and food，through the thoroughfare vessel. Therefore，the kidney plays a key role in the formation of phlegm. Professor CHEN Bo-Lai believes that low back pain of kidney deficiency and phlegm obstruction type is characterized by deficiency in the origin and excess in the superficiality. Excess in the superficiality is manifested as phlegm obstruction，and deficiency in the origin is manifested as kidney deficiency. Clinically，the patients with low back pain of kidney deficiency and phlegm obstruction type mainly have the manifestations of lumbosacral dull pain and fixed pain，stiffness in the waist， limb numbness or hemiplegia，accompanied by soreness and weakness of waist and knees，and preference for pressing and kneading. The treatment of low back pain of kidney deficiency and phlegm obstruction type can be based on theory of kidney being the root of phlegm，follows the therapy of tonifying kidney and eliminating phlegm， and can be performed by the modified use of basic prescription of Litan Decoction （mainly composed of Euryales Semen，Pinelliae Rhizoma，Sesami Semen Nigrum，Platycladi Semen，Paeoniae Radix Alba，Citri Reticulatae Pericarpium and Poria） together with the assistance of herbs for strengthening spleen and dispersing lung based on the differentiation of the complicated symptoms. The thoughts of Professor CHEN Bo-Lai for the differentiation and treatment of low back pain of kidney deficiency and phlegm obstruction type can be used as a reference for the treatment of low back pain with Chinese medicine.

R255.6

国家自然科学基金项目 （编号：82174396，82274554）；广东省普通高校创新团队项目 （编号：2021KCXTD020）；广州市科技计划 项目 （编号：202201020554，202201020324）；广州中医药大学中医学学科中医基础理论研究“揭榜挂帅”项目 （第二批）