2 English reference chronic nephritis
3 Summary Chronic nephritis is the abbreviation of chronic glomerulonephritis, which is a common and refractory chronic kidney disease. The clinical manifestations are edema, proteinuria, hematuria and hypertension. This disease is the most common among young people, and the incidence rate of men is higher than that of women. In recent years, it has been found that the incidence of the elderly is also on the rise. At present, the etiology and pathogenesis of chronic nephritis are still controversial, but most doctors believe that the disease is an immunoreactive disease related to infection, especially hemolytic streptococcus B infection, and modern medicine still lacks an ideal treatment for the disease.
According to the clinical manifestations of chronic nephritis, there are similar records of TCM syndromes such as edema, fatigue, low back pain and dizziness. As early as in Huangdi Neijing, there were many descriptions, such as Su Wen? "Hydrothermal acupoint theory says that ... water sickness is accompanied by a big belly, and the upper part is panting. Those who can't lie down are all sick." Very similar to chronic nephritis edema. "synopsis of the golden chamber" said: "those with kidney water, large abdomen, swollen umbilicus, low back pain, should not drown." Similar to chronic nephritis and low back pain. In the late stage of chronic nephritis, due to the decline of general function, the phenomenon of deficiency of both qi and blood and yin and yang appears, which is very similar to the symptoms of "strain" in traditional Chinese medicine. Chronic nephritis hypertension syndrome is similar to headache and dizziness in traditional Chinese medicine. The above shows that ancient physicians have a deeper understanding of this disease from different angles.
In modern times, as early as 1923, it was reported that Astragalus combined with Codonopsis pilosula treated nephritis proteinuria. Since 1950s, Chinese medicine has been widely used to treat chronic nephritis, mainly to warm and tonify kidney yang, but there is a lack of in-depth research in theory. In the mid-1960s, a national symposium on the treatment of chronic nephritis with traditional Chinese medicine was held in Chongqing, and the experience of this period was summarized and exchanged. In the 1970s, theoretical and experimental research on the diagnosis and treatment of this disease by traditional Chinese medicine was widely carried out in various places, and a large number of clinical explorations were carried out, which broadened the application of ancient prescriptions in this disease, determined the treatment principles of strengthening the body resistance and eliminating pathogenic factors, and improved the curative effect to a certain extent. Since 1980s, new progress has been made in the study of syndromes, laboratory and other objective diagnostic basis of chronic nephritis. According to the theory of chronic kidney disease and blood stasis blocking collaterals in traditional Chinese medicine, scandium patients with chronic nephritis often have increased blood viscosity and microcirculation disorder by means of hemodynamics and hemorheology. Based on this, the method of removing blood stasis and dredging collaterals was drawn up to improve the curative effect. According to statistics, the disappearance rate of urine protein in 1959 was only 12%, and it increased to 30% in 1963, and increased to about 40% in 1980s. The clinical complete remission rate rose from 17% ~ 22% in 1950s to 35.6% ~ 46.9% at present. From the analysis and comparison of more than 4000 cases of chronic nephritis, the remission rate is about 60%, and the total effective rate is about 90%, which shows that the combination of traditional Chinese medicine and traditional Chinese and western medicine has a certain curative effect on this disease and is gradually improving. Of course, further improving the cure rate of the disease is still one of the primary tasks in the future. At present, there is no effective treatment for uremia, which needs further study.
4 Etiology and Pathogenesis According to the long-term clinical practice of ancient and modern physicians, it is unanimously believed that the disease is caused by repeated attacks of pathogenic factors such as wind-cold, wind-heat, toxic heat and damp-heat; In addition, internal injuries, improper diet, wine, color, fatigue and other factors cause viscera deficiency. In particular, the dysfunction of lung, spleen and kidney leads to the disorder of the distribution and gasification of water and essence in the body, and the viscera are weakening day by day, while the external evil is repeatedly infected, leading to a vicious circle between viscera and between good and evil, forming the clinical characteristics of chronic nephritis with repeated attacks and long-term unhealed. Now described as follows:
Invasion of exogenous evil, feeling exogenous evil, repeated treatment, injury to viscera, resulting in lung, spleen and kidney dysfunction, water and fluid metabolism disorder. Wind evil is bound to the outside, lung qi is undeclared, lost in feng shui, incurable; The disease is caused by yang deficiency of spleen and kidney, retention of water and dampness or flooding.
Spleen and stomach weakness, spleen and stomach weakness or seven emotions failure, eating disorders, spleen and stomach damage, abnormal transport, subtle and lifeless, water and dampness are not transported, and water is flooding and causes disease.
Deficiency of kidney-qi, deficiency of kidney-qi or overwork, strain and internal injury, dysfunction of opening and closing gasification, failure of kidney-qi to turn gas into water, water vapor blocking and soaking in skin; Deficiency of kidney-yang, insufficiency of spleen and soil, loss of transport and transformation function, inability to transport water and dampness, deficiency of spleen and soil involving lung gold, inability to regulate lung qi, and declaration of water and gas loss. The interaction of lung, spleen and kidney leads to prolonged illness and is difficult to cure. If the kidney yin is below, the water does not contain wood, and the liver yang is on the high side, it will lead to dizziness. In addition, the disorder of the liver, qi stagnation and blood stasis can also complicate the disease and make it difficult to cure.
5 Syndrome Differentiation and Classification In clinical syndrome differentiation, the main symptom of this disease is edema, thus distinguishing exterior and interior, deficiency and excess, cold and heat, and viscera. In recent 40 years, the criteria for syndrome differentiation and typing of the disease have been formulated four times. According to this criteria and referring to various modern opinions on syndrome differentiation and typing, it can be summarized into the following six syndrome types:
1. Spleen deficiency, wet and sleepy complexion, floating yellow, eyelid edema in the morning, listlessness, weakness of limbs, anorexia, abdominal distension, loose stool, edema of lower limbs, and mental depression. The tongue is pale with white and wet fur, with teeth marks and thin pulse. This type is more common in the early stage of chronic nephritis with normal renal function.
2. Lung and kidney qi deficiency with edema of limbs, qi deficiency and fatigue, easy to catch a cold, backache, scanty urine, accompanied by cough and runny nose, headache and fever, itchy throat or dry pain. The tongue is pale or red, the coating is thin and white, and the pulse is slippery. This type is susceptible to exogenous pathogens, thus aggravating symptoms.
3. Yang deficiency with pale complexion, obvious edema or abdominal distension, chills in limbs, backache, fatigue, loss of appetite, short and red urine, loose stool, nocturnal emission, impotence, premature ejaculation, or irregular menstruation. The tongue is fat and tender, with teeth marks, white and smooth fur and weak pulse. This type is often related to excessive water and dampness, qi stagnation and blood stasis.
4. Yin deficiency of liver and kidney, dry eyes, blurred vision, dizziness and tinnitus, vexation, dry mouth and throat, backache and leg weakness, nocturnal emission, or irregular menstruation of women and mild edema of limbs. The tongue is red with little fur, and the pulse is thin or thin. This type is more common in patients with hypertension or those who take hormones for a long time.
5. Deficiency of both qi and yin leads to dull complexion, deficiency of qi and fatigue or easy to catch a cold, low-grade fever or fever of hands and feet in the afternoon, dry mouth and throat or long-term sore throat, and dark red throat. Red tongue, little fur, thin or weak pulse. This type is common in the late stage of chronic nephritis, with impaired qi and blood, no edema or mild clinical symptoms, low systemic function and weak symptoms.
6. Spleen and kidney decline, sallow or dull complexion, weak waist and knees, fatigue, loss of appetite, thin stool, nausea and vomiting, short or long urine, mild edema or no swelling, and even irritability. The tongue is pale, the coating is white and moist, and the pulse is heavy or thin. This type is more common in the late stage of chronic nephritis, and severe cases may have early manifestations of mild renal insufficiency.
The above six syndromes are common types. But clinically, various symptoms often permeate each other. Between internal organs. Qi, blood, yin and yang, deficiency and excess can cross. Therefore, we must carefully check and distinguish according to the condition, and we must not stick to it.
6 6. 1 The treatment standard is completely relieved: the symptoms and signs such as edema completely disappear, the urine protein test continues to be negative, or the 24-hour urine protein volume continues to be less than 0.2g, the urine red blood cells disappear under high magnification, the urine sediment count is normal, and the renal function is normal.
Basic remission: symptoms and signs such as edema basically disappeared, urine protein examination continued to drop by more than 50%, urine red blood cells did not exceed 3 under high magnification, and urine sediment count was close to normal. Renal function is normal or basically normal (the difference from the normal value is not more than 15%).
Improvement: Symptoms and signs such as edema have been obviously improved, urinary protein has been continuously reduced by 65,438+0 (+) or the amount of urinary protein has been continuously reduced by more than 25% in 24 hours. Under high magnification, urinary red blood cells are less than 5, and renal function is normal or improved.
Ineffective: There is no obvious improvement or aggravation in clinical manifestations and the above laboratory tests.
6.2 Classified treatment of spleen deficiency and dampness (1)
Treatment: Yiqi Jianpi, diuretic and detumescence.
Prescription: Radix Astragali 30g, Radix Codonopsis, Rhizoma Atractylodis Macrocephalae, Poria, Rhizoma Alismatis, Radix Stephaniae Tetrandrae15g, Herba Leonuri 30g, Rhizoma Dioscoreae and Coicis Semen 20g, and Pericarpium Arecae10g.
Addition and subtraction: urinary protein is mostly astragalus, adzuki bean and cicada slough; Herba Ephedrae, Semen Armeniacae Amarum and Perillae are added to the waist. Add Zanthoxylum bungeanum and Semen Plantaginis for swelling below waist; Abdominal distension is very accompanied by magnolia bark and woody root; Hematuria with Eclipta prostrata and blood clot.
Usage: daily 1 dose, decocted in water and taken twice.
Efficacy: 238 cases of this type of patients, using the prescription * * *, 90 cases were completely relieved, 84 cases were basically relieved, 48 cases were improved, and 16 cases were ineffective, with a total effective rate of 93.3%.
Commonly used prescriptions: Shen Ling Baizhu Powder or Huangqi Buzhong Decoction.
(2) Deficiency of lung and kidney qi
Treatment: tonify lung and kidney, relieve exterior symptoms and eliminate pathogenic factors.
Prescription: Ginseng10g, Radix Astragali, Poria, Lalang Grass Rhizome, Cornus officinalis, Radix Scrophulariae10g, Folium Mori, Alismatis Rhizoma, Poria10g, Rhizoma Dioscoreae 30g, and Radix Glycyrrhizae 6g.
Addition and subtraction: sore throat plus Rhizoma Belamcandae and Radix Isatidis; Hematuria plus thistle; Herba Ephedrae, Semen Armeniacae Amarum and Herba Houttuyniae are added for fever and cough.
Usage: decoct in water and take orally twice, daily 1 dose.
Efficacy: 13 1 case. After the above treatment, 30 cases were completely relieved, 43 cases were basically relieved, 47 cases were improved, and1case was ineffective. The total effective rate is 965438 0.6%.
Commonly used prescriptions: Yiqi Bushen Decoction, Huangqi Guizhi Wuwu Decoction, Ji Fang Huangqi Decoction and Ji Fang Fuling Decoction.
(3) Yang deficiency and hydration
Treatment: Warming kidney and strengthening spleen, promoting qi and promoting diuresis.
Prescription: Radix Aconiti Lateralis Preparata (decocted first), Herba Epimedii, Rhizoma Dioscoreae and Rhizoma Alismatis each 65,438 05g, Rhizoma Atractylodis Macrocephalae, Poria and Semen Plantaginis each 65,438 05g, Fructus Cucurbitae Moschatae 30g, Radix Salviae Miltiorrhizae and Herba Leonuri 20g.
Addition and subtraction: add Morinda officinalis and Rhizoma Curculiginis to form coldness; Palpitation relieving and asthma adding Semen Lepidii, Cortex Mori, Radix Stephaniae Tetrandrae and Herba Lycopi; Hematuria plus cogongrass rhizome; Edema has disappeared, and there is no need to add Rosa laevigata and Alpinia oxyphylla for proteinuria; Abdominal distension and flatulence after eating, add areca nut and immature bitter orange.
Usage: decoct in water and take orally twice, daily 1 dose.
Curative effect: 326 cases of this type of patients were treated with the prescription, 88 cases were completely relieved, 65,438+027 cases were basically relieved, 75 cases were improved and 36 cases were ineffective. The total effective rate was 89.2%.
Commonly used prescriptions: Shipiyin, Zhenwu Decoction and Jisheng Shenqi Pill.
(4) Yin deficiency of liver and kidney.
Treatment: nourishing liver and kidney, calming liver and suppressing yang.
Prescription: Radix Rehmanniae, Carapax et Plastrum Testudinis, Cornus officinalis, Cortex Moutan and Achyranthes bidentata each 65438±05g, Radix Paeoniae Alba, Concha Haliotidis (parched) and Radix Salviae Miltiorrhizae each 30g, Herba Leonuri 20g, Fructus Ligustri Lucidi 65438±02g, Fructus Lycii and Periostracum Cicadae each 65438±00g.
Addition and subtraction: dizziness plus Gastrodia elata and Uncaria; Sore throat plus Scrophularia; Adding Semen Plantaginis and Radix Stephaniae Tetrandrae for edema; Epistaxis plus cogongrass rhizome. ? -
Usage: decoct in water and take orally twice, daily 1 dose.
Curative effect: 2 13 * * from the top, 62 cases were completely relieved, 76 cases were basically relieved, 52 cases were improved, and 23 cases were ineffective. The total effective rate was 89.2%.
Common prescriptions: Qiju Huangdi Decoction or Huangdi Yinzi.
(5) Deficiency of both Qi and Yin
Treatment: supplementing qi, nourishing yin and enriching blood.
Prescription: Ginseng 65438 00 g, Radix Astragali, Cornus officinalis, Radix Rehmanniae Preparata, Poria and Eclipta prostrata 65438 00 g, Rhizoma Dioscoreae and Radix Salviae Miltiorrhizae 20 g, Radix Angelicae Sinensis and Fructus Lycii 65438 02 g.
Add and subtract: sore throat, Gaza ginseng, Ophiopogon japonicus; Radix Aucklandiae and Fructus Amomi are added for anorexia and abdominal distension; Radix Scrophulariae, Semen Platycladi and Radix et Rhizoma Rhei are added to the dry stool.
Usage: decoct in water and take orally twice, daily 1 dose.
Efficacy: 199 cases of this type of patients, 76 cases were completely relieved, 56 cases were basically relieved, 44 cases were improved, and 23 cases were ineffective. The total effective rate was 88.4%.
Commonly used prescription: Shenqi Dihuang Decoction.
(6) Splenic renal failure
Treatment: invigorating spleen and kidney, reducing turbidity and eliminating dampness.
Prescription: Radix Aconiti Lateralis Preparata10g (decocted first), Radix Ginseng10g (decocted separately), Radix et Rhizoma Rhei 5 5- 10/0g (below), Poria12g, Fructus Aurantii, Rhizoma Pinelliae, Pericarpium Citri Tangerinae10g.
Addition and subtraction: bloating with Magnolia Officinalis and Amomum villosum; Urine less with Polyporus and Alisma orientalis.
Usage: decoct in water and take orally twice, daily 1 dose.
Curative effect: 15 1 case. After more than * * * treatment, 22 cases were completely relieved, 62 cases were basically relieved, 49 cases were improved, and 18 cases were ineffective. The total effective rate was 88.08%.
Common prescriptions: Huanglian Wendan decoction or Sijunzi decoction combined with Wuzi Yanzong decoction.
Chronic nephritis is complicated, with different pathological changes and clinical manifestations, and various types can be transformed into each other. Therefore, the treatment should be based on syndrome and give full play to the advantages of various therapies of traditional Chinese and western medicine in order to better improve the curative effect.
6.3( 1) Prescription Treatment of Yishen Decoction
Composition: 25g of Radix Astragali, 25g of Radix Rehmanniae 15g, Poria 15g, Rhizoma Dioscoreae, Radix Stephaniae Tetrandrae, Rhizoma Polygonati, Rhizoma Cibotii, Radix Dipsaci, Herba Taraxaci, Fructus Toosendan, Glycyrrhrizae Radix, Atractylodis Macrocephalae, Rhizoma Imperatae, Fructus Lycii, 25g, and 50g of Flos Lonicerae.
Usage: decoct, morning and evening 1 time, daily 1 dose. 1 month is a course of treatment, taking it for 2 ~ 3 courses continuously, and stopping using other drugs during the observation period.
(2) Yiqi Wenshen Huoxue Decoction
Composition: Radix Codonopsis and Radix Astragali each 30-60g, Radix Angelicae Sinensis, Fenugreek, Herba Cynomorii, Herba Leonuri, Radix Achyranthis Bidentatae, Pyrola and Xu Changqing each10-15g.
Addition and subtraction: kidney-yang deficiency plus aconite, epimedium and curculigo; Kidney yin deficiency plus Cornus officinalis, Radix Rehmanniae and Rhizoma Anemarrhenae; Adding Saviae Miltiorrhizae Radix and Hirudo to remove blood stasis; Moisturizing, adding Alisma orientale, Semen Plantaginis and Poria.
Usage: daily 1 dose, decocted in water, morning and evening 1 time.
Curative effect: This prescription treats edema 163 cases, in which 93 cases of edema completely subside, 38 cases are relieved and 32 cases remain unchanged, with a total effective rate of 80.3%. In the treatment of 237 cases of proteinuria, 88 cases completely disappeared, 95 cases decreased more than 1(+), 44 cases remained unchanged, and 10 cases worsened, with a total effective rate of 77.2%.
(3) Qingxin Lianzi Drink
Composition: Scutellariae Radix and Cortex Lycii 20g each, Ophiopogon japonicus, Plantaginis Semen, Bupleuri Radix, Lotus Seeds and Poria15g each, Radix Astragali, Radix Codonopsis 50g each, and Radix Glycyrrhizae 5g each.
Addition and subtraction: dry throat and sore throat, reduce the amount of Radix Astragali and Radix Codonopsis, and add Flos Lonicerae, Herba Hedyotidis Diffusae and Fructus Forsythiae; Remove edema of Glycyrrhiza uralensis Fisch, and add mother and winter melon skin; The waist and knees are sore, and Eucommia ulmoides, Ligustrum lucidum, Cornus officinalis and Eclipta prostrata are added; Adding Pollen Typhae charcoal, Herba Leonuri, Herba et Gemma Agrimoniae and Colla Corii Asini to treat polycythemia in urine; Leukocytosis plus Herba Polygoni Avicularis, Herba Dianthi, Herba Taraxaci, and Herba Violae.
Usage: decoct in water, once in the morning and once in the evening, daily 1 dose.
Therapeutic effect; * * * 86 cases were observed, 30 cases were completely relieved, 22 cases were basically relieved, 5 cases were improved, and 9 cases were unchanged/kloc-0. The total effective rate was 77.9%.
(4) Zhuo Qing Shenfu Decoction
Composition: Radix Astragali and Radix Morindae Officinalis each 30g, Rhizoma Imperatae, Rhizoma Atractylodis Macrocephalae and Rhizoma Dioscoreae each 20g, cornu Cervi Degelatinatum, Fructus Corni and Semen Ziziphi Spinosae each 65438 05g, Caulis Akebiae and Cortex Cinnamomi each 65438 00g, and Fructus Amomi each 9g.
Add and subtract: spleen-kidney yang deficiency combined with Jingui Shenqi Pill.
Usage: decoct in water, once in the morning and once in the evening, daily 1 dose. Jinkui Shenqi Pill is taken before meals, three times a day, each time 1 capsule.
Curative effect: 38 cases were observed, 25 cases were completely relieved, 8 cases were basically relieved and 5 cases were improved. After taking about 15 dose, proteinuria began to improve, urine output increased, edema subsided and symptoms improved.
(5) Wuchong Decoction
Composition: 5g of cicada slough, 9g of prepared Bombyx Batryticatus, 9g of earthworm, 9g of Zaocys, 3g of Eupolyphaga Seu Steleophaga, 0g of raw Astragalus membranaceus15g, 0g of motherwort15g, cogongrass rhizome15g, 30g of Pyrola, 0g of Poria15g, and motherwort.
Addition and subtraction: Qi deficiency plus Astragalus membranaceus and Codonopsis pilosula; Semen Cuscutae and Radix Aconiti Lateralis Preparata are added for yang deficiency; Yin deficiency plus yam, dogwood and Broussonetia papyrifera; Blood stasis plus salvia miltiorrhiza.
Usage: decoct in water and take it twice, daily 1 dose.
Efficacy: 34 cases of chronic nephritis proteinuria were treated with this recipe, 5 cases were basically relieved, 26 cases were improved and 3 cases were ineffective. The total effective rate is 965438 0.2%.
6.4 Zou Yunxiang's Medical Records of Old Chinese Medicine
Zhou XX, male, 17 years old. First visit on June 23rd, 1975. He suffered from chronic nephritis for 7 years and failed to be cured for a long time. Mental fatigue, backache and cold, anorexia, loose stool, edema, yellow complexion, thready pulse and white fur. Urine test: protein (++), less red blood cells, less white blood cells (++), a little transparent cast, a little granular cast. The disease lies in the spleen and stomach, yang impairs yin, and both qi and blood are deficient. This prescription aims at tonifying kidney, regulating yin and yang, and nourishing qi and blood.
Prescription: Radix Astragali 24g, Eucommiae Cortex 12g. Decocted with wine, Radix Achyranthis Bidentatae 9g, Radix Codonopsis 18g, fried atractylodes 12g, Rhizoma Dioscoreae 15g, Poria 9g, Radix Aconiti Lateralis Preparata 5g, Fructus Lycii 12g, Radix Rehmanniae 5g and Radix Angelicae sinensis 9g. Decoct with water.
It was removed from the top and came to July 2nd. The urine test showed that the protein (++), cast were gone, red blood cells (++) and white blood cells (++). After taking 33 doses, the condition improved obviously, the appetite increased, the stool was normal and the edema was reduced. August 13, urine test showed that there were few protein (+) red blood cells and white blood cells, which were still consolidated according to the original prescription.
Huangdi Neijing said: "Those who are deficient in form should be warmed with qi, while those who are deficient in essence should be supplemented with flavor." Zhang Jingyue notes: "Deficiency of form leads to yang decline, while deficiency of warm essence leads to yin decline, and deficiency of non-taste can not make up for it. "According to this theory, Zou Lao nourishes its shape with Radix Astragali, Radix Codonopsis and Rhizoma Atractylodis Macrocephalae, supplements its essence with whole deer pill, Eucommia ulmoides, Achyranthes bidentata, Lycium barbarum, Chinese yam, Rehmannia glutinosa, Angelica sinensis and Radix Paeoniae Alba, warms the yang of the spleen and stomach with aconite, and excretes it with Poria and Coicis Semen. Zou Lao stressed that this kind of chronic disease, the agent of nursed back to health, must be constantly maintained in order to be effective.
6.5 Drug Use Regularity From 2 13 clinical reports, 97 self-made prescriptions with good curative effect on chronic nephritis were screened out, and the drug use frequency was counted to find the drug use regularity of chronic nephritis. According to statistics, * * * used 76 kinds of drugs. The list is as follows:
Frequency of application (example)
Report (article)
Medicine? thing
>2500
>60
Radix Astragali, Poria, Atractylodis Rhizoma.
>55
Chinese yam, motherwort.
200 1~2500
>50
Dangshen and Alisma orientalis.
100 1~2000
>35
Cornus officinalis, Radix Rehmanniae and Semen Plantaginis.
>30
Saviae Miltiorrhizae Radix, Fructus Lycii.
>20
Glycyrrhrizae Radix, Coicis Semen, Lalang Grass Rhizome, Radix Angelicae Sinensis.
70 1~ 1000
>20
Cortex Moutan, Semen Euryales, Radix Aconiti Lateralis Preparata, Achyranthis Radix.
40 1~700
> 15
Radix Pseudostellariae, Eclipta prostrata, Radix Paeoniae Rubra, Radix Rehmanniae Preparata, Ramulus Cinnamomi, Cortex Cinnamomi, Periostracum Cicadae, and Pericarpium Citri Tangerinae.
> 10
Dandelion, Ophiopogon japonicus, Ligustrum lucidum, pink, safflower, epimedium and Cherokee rose.
< 10
Herba Taxilli, Flos Lonicerae, Radix Stephaniae Tetrandrae, Radix Dipsaci, Rhizoma Polygonati, Semen Cuscutae, Rhizoma Cibotii, and Placenta Hominis.
200~400
> 10
Chuanxiong rhizome, earthworm.
5~ 10
Rhizoma Atractylodis, Fructus Toosendan, Pericarpium Arecae, Eucommiae Cortex, Polyporus, Rhizoma Anemarrhenae, Herba Hedyotidis Diffusae, Herba Lycopi, Fructus Forsythiae, Carapax et Plastrum Testudinis, Scutellariae Radix, Rhizoma Curculiginis, Lobelia Chinensis, Tripterygium Wilfordii, Radix Scrophulariae, Cynomorium songaricum, Radix Paeoniae Alba, Fenugreek, Xu Changqing and Herba Pyrolae.
> 100
5~ 10
Radix et Rhizoma Rhei, Fructus Amomi, Radix Morindae Officinalis, Concha Ostreae, Herba Cistanches, Flos Chrysanthemi, Semen Phaseoli, Concha Haliotidis, Radix Aucklandiae, Radix Saposhnikoviae and Fructus Schisandrae Chinensis. As can be seen from the above table, the most commonly used drugs for treating this disease are spleen-invigorating and qi-invigorating drugs, such as Astragalus membranaceus, Codonopsis pilosula, Atractylodes macrocephala, yam and so on. , followed by drugs that tonify the kidney, such as Cornus officinalis, Radix Rehmanniae and Fructus Lycii. At the same time, it is compatible with blood-activating drugs, such as Poria, Alisma orientalis, Plantaginis Semen, Coicis Semen, drugs for warming kidney and strengthening yang, or drugs for nourishing yin and tonifying kidney, such as Astragalus membranaceus and Leonurus japonicus, which have the functions of strengthening the body resistance, promoting blood circulation and removing blood stasis, and can improve the immune function of the kidney. It has a certain effect on turning urinary protein negative, improving renal function and preventing uremia.
6.6 Other therapies (1) Acupuncture
① Body acupuncture therapy
Acupoint selection: Main acupoints: A. Ganshu, Pishu, Shenshu, Fructus Aurantii Immaturus, Yangfei and Taixi; B. Zhongshan, Qiwei, Zhongyu, Yishu, Qihai, Sanyinjiao, Fuliu and Jinggu. Matching points: Yang deficiency increasing vertebra, Mingmen and Guanyuan; Yin deficiency plus Jingmen and Shu Ge; Surface floating limb swelling plus Renzhong, Yinlingquan, Sanjiaoshu and Bladder Shu; Hypertension plus Taichong and Zusanli points; Sore throat plus Hegu and Tianding; There is tenderness in the chest, plus Yu Fu and Bu Lang; Renal insufficiency plus 5 ~ 7 spinal chest clips.
Operation: mainly select 3 ~ 4 points, and select two groups of points in turn. Choose acupoints according to symptoms. Mainly acupuncture, combined with moxibustion. With a 30-gauge needle, gently twist the needle until it gets angry, then lie down and leave the needle for 20 ~ 30 minutes. During the needle retention, gently twist the needle every once in a while. Rhombic moxibustion of Dazhui, Mingmen and Guanyuan, 5-7 strong each time. Acupuncture twice a week, 15 ~ 20 times is a course of treatment, and the treatment interval is about 1 week.
Efficacy: * * 15 cases, basic remission in 5 cases, improvement in 3 cases and ineffectiveness in 7 cases, with a total effective rate of 53.3%.
② Frozen acupuncture
Acupoints: Shenshu and Jinggu.
Operation: Take one acupoint at a time and use it alternately. Treatment of furuncle with semiconductor frozen acupuncture instrument: the needle body temperature is kept at 0 ~ 15℃, and the needle is held for 10 minutes, once a day, 7 times as a course of treatment, which can last for two courses.
Efficacy: 30 cases were treated with * * * *. After treatment, urinary protein disappeared or basically disappeared 17 cases, accounting for 56.7%, and decreased 13 cases. 13 cases of urinary catheter type, 7 cases disappeared after treatment, 4 cases decreased, 2 cases were ineffective, and the total effective rate was 84.6%.
(2) Single prescription
① Shenyankang Capsule
Ingredients: medicinal fungi? Shenbao polysaccharide capsules were made by submerged fermentation, each containing 65438±000mg.
Usage: Take 2 capsules orally, three times a day, and the daily dosage is about 600 mg of Shenbao polysaccharide.
Curative effect: 349 cases were observed, 87 cases were completely relieved, 98 cases were basically relieved, 49 cases were ineffective, and the total effective rate was 85.96%.
② Mung bean aconite decoction
Composition: 30g mung bean and 30g aconite.
Usage: eat beans after boiling, add 30 grams of mung beans to cook beans the next day, and cook them with prepared aconite and mung beans on the third day as before. Avoid cold salt wine for 60 days. It is suitable for patients with chronic nephritis whose edema tends to yang deficiency.
③ Corn silk soup
Composition: 60g of corn stigma, 30g of Lygodium japonicum and 60g of verbena.
Usage: decoct in water and take it twice, daily 1 dose. This prescription is suitable for edema and dysuria.
(3) Qigong
Achievement method: three-line relaxation: sitting or lying down, abdominal breathing is the main method, and the six-character formula practices the word "blowing" and is supplemented by the method. It is intended to guard the abdomen, the door of life, and cooperate with the sacred tree. Hypertension plus Yongquan and Datun; Hematuria plus spring; Nadejia Zusanli. Pose, say the word "loose" silently, and relax from top to bottom in three lines: side, front and back. When practicing relaxation, first pay attention to one part and recite the word "loose", then pay attention to the other part and recite the word "loose" in turn. Then, put your thoughts on your navel. This process, as a cycle, keeps quiet every morning 1 time, each time 1 ~ 3 cycles, and then calls it a day.
Efficacy: * * 30 cases were observed, including complete remission 16 cases, basic remission 1 case, improvement1case, and 3 cases were ineffective. The total effective rate is 90%.
(4) dietotherapy
① Proteinuria porridge
Composition: Gordon Euryale 30g, Ginkgo biloba 10, glutinous rice 30g.
Administration method: The three ingredients are cooked in porridge at the same time, 1 time per day, with 1 day as a course of treatment, and taken intermittently for 2-4 courses of treatment (less eaters, Euryale euryales, glutinous rice15-20g).
Efficacy: 73 cases were treated with * * * *, and the total effective rate was 89.65438 0%.
② Braised pork belly with turtle.
Composition: 1 turtle (about 500g) and 50g pork belly.
Administration method: clean and cut into small pieces, stew with slow fire into paste without salt, and take 1 time every morning and evening for 2 days, and then take 1 dose every other day, with 3 doses as a course of treatment.
Efficacy: 23 cases of chronic nephritis proteinuria were treated, with complete remission 10 cases, basic remission in 8 cases, improvement in 3 cases and ineffectiveness in 2 cases. The total effective rate is 965438 0.3%.
③ Broad bean syrup
Ingredients: aged broad beans (preferably stored for several years)120g, brown sugar 90g.
How to take it: Put the shelled broad beans and brown sugar into a casserole, add 5 cups of clear water, and simmer until 1 cup. Eat on an empty stomach in the morning and finish it in 5 days.
Efficacy: * * 18 cases, the effective rate was 77.78%.
6.7 Other measures When edema is obvious and blood pressure is high, you should stay in bed, avoid salt diet, and eat less salt when there is no edema. When physical strength permits, do some outdoor activities to adapt to seasonal changes and avoid chronic diseases induced by respiratory tract infections such as "upper respiratory tract infection". Avoid cold, dampness, excessive fatigue and the use of drugs harmful to the kidneys, and control the occurrence of infectious diseases.
Acupoint waist acupuncture has the effect of treating chronic nephritis, but it has diuretic effect on patients with nephropathy and oliguria. For patients with chronic nephritis or hypertension with proteinuria, urinary protein can be reduced or disappeared. The life gate of making a tree is ...
Ankle door, constipation. Anmen is combined with Shenshu, Sanjiaoshu, Zhongji and Yinlingquan to treat acute and chronic nephritis. Xiangmen is combined with Ganshu, Pishu and Yanglingquan to treat jaundice and vomiting. Ankle door ...
Big warehouse is not good. Sanjiaoshu is combined with Dachangshu, Qihai, Zhongji and Zusanli to treat acute and chronic nephritis. Sanjiaoshu is combined with Ganshu, Pishu and Yanglingquan to treat jaundice and vomiting. three ...
So it is not suitable. Sanjiaoshu is combined with Dachangshu, Qihai, Zhongji and Zusanli to treat acute and chronic nephritis. Sanjiaoshu is combined with Ganshu, Pishu and Yanglingquan to treat jaundice and vomiting. three ...
Shenshu