Abstract:This paper will review the research on the name, etiology and classification of chronic renal failure in the past 30 years, and propose to strengthen the research on clinical signs and symptoms as a breakthrough to standardize the classification of TCM, improve clinical efficacy and achieve comparability of efficacy evaluation. According to the clinical evolution of chronic renal failure, it belongs to “drowning toxicity”, “Guange”, “retention of urine”, “kidney wind”, and “kidney wind” in Chinese medicine. Kidney wind”, “edema”, “deficiency labor”, “kidney labor”, etc. There are two main views on the name of chronic renal failure among renowned experts. Some experts believe that chronic renal failure belongs to the category of multiple diseases in Chinese medicine. For example, Ye Rengao, Fang Yazhong and Shi Zhenying have classified chronic renal failure as “Guange”, “edema”, “retention of urine”, “deficiency labor” and “drowning poison” in Chinese medicine. “, “Drowning Poison”, “Kidney Wind”, “Water Gas Disease”, “Urine Poison” and so on. Some other experts advocate that chronic renal failure should be summarized by a TCM disease name, such as Ren Jixue, who believes that chronic renal failure should be named “deficiency renal failure”, and Zou Yanqin, who believes that chronic renal failure belongs to the category of “renal labor” in TCM. According to the national standard “Chinese Medicine Clinical Treatment Terminology” compiled by Zhu Wenfeng and Wang Yongyan, chronic renal failure in modern medicine is now uniformly named as chronic renal failure in Chinese medicine. Shao Minghai, Department of Nephrology, Shanghai Shuguang Hospital, West Hospital I. Causes and mechanisms Regarding the causes, it is generally believed that there are three aspects: 1. external evil attack, from the surface into the inside, the condition is repeated and aggravated; 2. mental trauma or excessive thinking, indiscipline in the room, abnormal living; 3. there is a deficiency of lung, spleen and kidney, and then triggered by external evil, or overwork, or improper treatment, so that the internal organs, yin and yang, qi and blood are further imbalanced, wind, cold, dampness, heat, stasis, poison and other real evil. The actual evil such as wind, cold, dampness, heat, stasis, and toxicity may develop. In “Su Wen Jue Pain Theory”, it is said that “labor depletes qi”; “Su Wen? In the treatise on vital energy, it is said that “if we exert ourselves, our kidney energy will be injured. Zheng Pingdong divided the causes of chronic renal insufficiency into “primary cause”, “primary cause” and “causative cause”. “The “primary cause” is the deficiency of the spleen and kidneys; the “primary cause” is the loss of the function of separating the clearing and secretion of turbidity due to prolonged kidney disease, which causes “dampness and turbidity” to be stored in the body and diffuse through the three jiao This disease is caused by the loss of the “dampness and turbidity” in the body, which spreads to other internal organs. This “dampness and turbidity” He Lianchen called “drowning poison”, and said “drowning poison into the blood, blood poison into the brain”. The “cause” is the sudden feeling of external evil, the lung qi is not pronounced, the treatment section is out of order, the water channel of the three jiao is not conducive, and the dampness and turbidity are stored in addition to the existing spleen and kidney deficiency, after the sudden feeling of external evil, the spleen and kidney damage is even worse; or poor diet, or excessive exertion, damage to the spleen and stomach, and the spleen and kidney deficiency is aggravated. Regarding the mechanism of the disease, most doctors believe that it is mainly the result of the malfunctioning of the internal organs and the lack of differentiation between the clear and turbid and the rebellious, which is the result of the deficiency of the root and the symptoms of the disease, with the spleen and kidney as the main organs. Around the characteristics of the pathogenesis of deficiency, many physicians have conducted in-depth discussions from different perspectives. For example, Ye Rengao believes that the disease is characterized by the deficiency of the original and the actual, with the deficiency of the spleen and kidney and the retention of toxins as the key to the disease mechanism. In the formula, the pathogenesis of chronic renal failure is considered to be positive deficiency and evil actuality, with deficiency giving rise to evil and deficiency causing actuality; the location of the disease is either in the spleen, kidney, or spleen-kidney; the nature of the disease is deficiency, either as qi deficiency, yang deficiency, blood deficiency, yin deficiency, or qi deficiency, blood deficiency, yin deficiency, or both qi and yin deficiency at the same time. According to Zhang Qi, chronic renal failure is an advanced stage of many kidney diseases, with deficiency of the spleen and kidney as the root cause and retention of dampness as the symptom. The key to the pathogenesis is the dysfunction of the kidney in separating clearing and secretion of dampness, and deficiency of positive energy is the main cause of the disease. Zou Yanqin believes that chronic renal failure is a symptom of renal failure, retention of dampness and toxicity, and a mixture of deficiency and reality that occurs at the end of various chronic kidney diseases. Liu Baohou believes that the disease is a severe case of deficiency of the root and the symptoms of the disease, and that the failure of the spleen and kidney, retention of water and toxins, and dampness are the key to the disease mechanism. Zheng Pingdong believes that there are four major pathological mechanisms in the formation of this disease: deficiency, actuality, stasis and toxicity, among which deficiency is the basic pathological mechanism of this disease, and kidney deficiency is the center of the disease, which spreads to heart, liver, spleen and lung organs over time. In 1983, at the first meeting of the Kunming Branch of the National Association of Chinese Medicine, the criteria for typing chronic nephritis were formulated, and chronic nephritis was divided into three stages, namely, edema stage, renal labor stage, and renal failure stage. Among them, renal labor and renal failure stage is chronic renal failure. In the stage of renal labor, the TCM identification is divided into spleen and kidney qi deficiency, liver and kidney yin deficiency, kidney yuan deficiency, kidney deficiency damp heat, and kidney deficiency stagnation; in the stage of renal failure, it is divided into positive deficiency and evil real dampness and turbidity gathering, and kidney yuan failure and turbidity congestion. The TCM classification criteria for chronic renal failure formulated at the Second National Academic Classification Conference of Chinese Medicine for Kidney Diseases in 1985 were divided into spleen and kidney qi deficiency, spleen and kidney yang deficiency, liver and kidney yin deficiency, and yin and yang both deficiency. In 1987, the “Criteria for the Classification of Chronic Kidney Failure in Chinese Medicine and Determination of Therapeutic Effect” adopted at the Tianjin Conference and the criteria for the classification of chronic kidney failure in Chinese medicine adopted at the Third Academic Conference on Chinese Medicine and Kidney Diseases of the Chinese National Association of Traditional Chinese Medicine later on, both classified chronic kidney failure into five types of positive deficiency and eight types of evil reality, with positive deficiency being the main type and evil reality. The five types of positive deficiency are: spleen and kidney qi deficiency, spleen and kidney yang deficiency, liver and kidney yin deficiency, qi and yin deficiency, and yin and yang deficiency; the eight types of evil deficiency are external sensation, phlegm and heat, water and qi, dampness and turbidity, damp heat, blood stasis, wind movement, and wind dryness. In 1993, the State Ministry of Health promulgated the “Clinical Research Guidelines for New Drugs in Chinese Medicine”, in which the “Clinical Research Guidelines for New Drugs in Chinese Medicine for the Treatment of Uremia” mainly classifies chronic renal failure into the following types: deficiency of spleen and kidney qi (yang), deficiency of both spleen and kidney qi and yin, deficiency of liver and kidney yin, deficiency of both yin and yang, and actual evidence of entrapped evil (dampness, water and blood stasis). In 2002, the Guidelines for Clinical Research on New Chinese Medicines classified chronic renal failure into five types of positive deficiency, including spleen-kidney qi deficiency, spleen-kidney yang deficiency, spleen-kidney qi and yin deficiency, spleen-kidney yin deficiency, and yin-yang deficiency, and five types of positive deficiency, including dampness, damp-heat, water, blood stasis, and wind movement. In 2006, He Liqun authored the Chinese Society of Traditional Chinese Medicine (CCM) Nephrology Branch published the Diagnosis, Identification and Classification of Chronic Renal Failure and Assessment of Curative Effectiveness (Trial Program): the five types of positive deficiency are: spleen-kidney qi deficiency, spleen-kidney yang deficiency, liver-kidney yin deficiency, qi-yin deficiency, and yin-yang deficiency; the five types of concurrent evidence are dampness, damp-heat, heat toxicity, blood stasis, and wind movement. 2.Expert experience in typing Ye Rengao divided chronic renal failure into primary and secondary evidence and typology according to the priority of the symptoms. The five types of evidence: spleen-kidney qi deficiency, spleen-kidney yang deficiency, liver-kidney yin deficiency, qi-yin deficiency, and yin-yang deficiency; the three types of symptoms: dampness and turbidity offending the stomach, turbidity and yin reversal, and liver-yang hyperactivity. Liu Baohou divided chronic renal failure into four types based on the outline of qi and blood in the internal organs: spleen and kidney qi deficiency and blood stasis, liver and kidney yin deficiency and internal movement of liver wind, spleen and kidney yang deficiency and heart yang deficiency, and qi and yin deficiency and blood heat delusion. Wang Yongjun divided chronic renal failure into three types: two deficiencies of the spleen and kidney, dampness and turbidity in the blockage, liver and kidney yin deficiency and kidney deficiency, turbidity and toxicity in the retention type. Zheng Pingdong believes that this disease should be combined with the deficiencies of the five organs to identify and treat more clinically relevant, and can be divided into kidney disease and spleen, with turbidity upward (including turbidity heat and turbidity cold); kidney disease and liver, with internal movement of liver wind; kidney disease and heart, with yang exhaustion and evil trapping (including heart yang failure, evil trapped in the pericardium); kidney disease and lung, with lung and kidney failure. 3, modern clinical epidemiological investigation and study of common typology Lv Renhe will 250 cases of chronic renal failure patients, the pathogenesis into three types of five symptoms, three types of Qi and blood Yin deficiency, turbid poison internal stagnation type 54 cases, Qi and blood Yang deficiency, turbid poison internal stagnation type 59 cases, both Qi and blood Yin and Yang deficiency, turbid poison internal stagnation type 137 cases; five symptoms are gastrointestinal stagnation, turbid poison injury blood, water Ling heart and lung, liver wind internal movement, poison violation of the pericardium. Yang Xiao et al. investigated 681 clinical cases and revealed that there are differences in the distribution of TCM evidence types at different stages of CRF from the perspective of positive deficiency. The basic pathogenesis of positive deficiency is deficiency of spleen and kidney, while the compensated, decompensated and failing stages are dominated by deficiency of both qi and yin, while the uremic stage is dominated by deficiency of spleen and kidney yang and deficiency of both yin and yang, while deficiency of spleen and kidney qi and deficiency of liver and kidney yin are phased in the course of the disease. In addition, blood stasis and damp-heat were significantly more frequent than the other evil and real evidence in the whole course of the disease. Li Shuhui clinically observed 126 inpatients with CRF and found that the proportion of each TCM evidence type differed at the beginning of the disease due to the different primary diseases, and as the disease progressed, the proportion of spleen-kidney-yang deficiency evidence, which was the majority at the beginning of CRF, gradually decreased while the proportion of qi-yin two deficiency evidence gradually increased; with the prolongation of the disease, qi-yin two deficiency and yin-yang two deficiency evidence gradually increased while spleen-kidney-yang deficiency evidence gradually decreased. Sun Shengyun et al. observed the relationship between the TCM evidence types in 210 cases of chronic renal failure, and the results showed that positive deficiency evidence was most common in the spleen-kidney qi deficiency type, followed by qi-yin two deficiency type, and least in the yin-yang two deficiency type. The clinical manifestations of two or more evil-reality evidence can occur simultaneously, and the most frequent occurrence of various evil-reality symptoms in uremia. Through the investigation and analysis of 200 cases of chronic renal failure, Nie Lifang confirmed that the pathomechanism of chronic renal failure is that the original deficiency is mixed with the real, and the deficiency is mixed with the real. The main deficiency is qi and yin deficiency, followed by yin and yang deficiency and spleen and kidney qi deficiency. Spleen-kidney yang deficiency and liver-kidney yin deficiency alone are rare. The disease is located in the spleen, kidney and liver. The main evil is damp-heat, followed by wind-dryness, wind-motion, water-qi, blood-stasis, and dampness, and several evils can be seen simultaneously in one case. The onset of chronic renal failure is mostly after the age of 40, with more women than men. The treatment of chronic renal failure should be based on benefiting qi and nourishing yin, taking into account the elimination of evil, and warm and dry drugs should be used with caution. He Liqun et al. showed that the total occurrence rate of the evidence of positive deficiency differed significantly, with the evidence of spleen and kidney qi deficiency and qi-yin deficiency being significantly higher than the other evidence types, but there was no significant difference in the total occurrence rate between the two, and the evidence of liver and kidney yin deficiency and yin-yang deficiency was significantly less than the other evidence types. The symptoms of evil reality were dominated by blood stasis, damp-heat and dampness. In addition, Chen Yiqing et al. analyzed some 270 papers on the prevention and treatment of chronic renal failure in Chinese medicine in the past 10 years and concluded that the main types of chronic renal failure were spleen and kidney qi (yang) deficiency, qi and yin deficiency, liver and kidney yin deficiency, and yin and yang deficiency. Shao Zenghai et al. concluded that in all periods of chronic renal failure, spleen-kidney qi deficiency is absolutely dominant among the evidence of deficiency, while dampness, heat, stasis and blood are the main symptoms of symptomatology. Conclusion: In conclusion, chronic renal failure belongs to the “drowning toxicity”, “Guange”, “retention of urine”, “kidney wind” and “edema” in Chinese medicine. In conclusion, chronic renal failure belongs to the categories of “Drowning Poison”, “Guange”, “Retention of urine”, “Kidney Wind”, “Edema”, “Void Labor”, “Kidney Labor” in Chinese medicine, and so on. The pathogenesis is mainly the result of the malfunction of the internal organs, and the rebellion caused by the indistinguishability of clear and turbid, which is considered by most experts to be the evidence of deficiency of the root and the symptoms, with the spleen and kidneys as the main sites of the disease. The clinical classification is based on both positive and negative aspects, and is often based on positive deficiency as the outline and negative reality as the objective. The positive deficiency is spleen and kidney qi deficiency, spleen and kidney yang deficiency, liver and kidney yin deficiency, qi and yin deficiency, and yin and yang deficiency; the negative reality is divided into dampness and turbidity, damp heat, heat toxicity, blood stasis, wind movement, etc. In the future, we must strengthen the investigation and research of clinical signs and symptoms, and through the exploration of the distribution and evolution pattern of symptoms, objectify and standardize the diagnostic criteria and efficacy evaluation criteria, so as to enhance the operability of the quantitative criteria of symptoms, improve the scientific, advanced and practical research of the standardization of symptoms of chronic renal failure, and provide a more comprehensive scientific basis for the classification of Chinese medicine, improvement of clinical efficacy and efficacy evaluation. The scientific basis of the study is to improve the standardization of chronic renal failure.