Syndrome Differentiation And Treatment Of Nephrotic Syndrome in TCM
Sep 15, 2022
Nephrotic syndrome refers to a group of syndromes in glomerular diseases, which can be divided into primary and secondary clinically. It accounts for 70% to 90% of glomerular diseases in children and 20% to 30% in adults.
Patients with clinical features such as massive proteinuria (>3.5g per day), hypoalbuminemia (albumin<30g/L), obvious edema, and dyslipidemia (serum cholesterol>6.5mmol/L), can be diagnosed as nephrotic syndrome.
This disease belongs to the categories of "edema" and "consumption" in traditional Chinese medicine, and clinical treatment needs to be based on the type of pathological syndrome——
Damp Heat Inner Syndrome
Main symptoms: obvious swelling, tight skin, abdominal fullness, chest tightness and irritability, dry mouth, dry stool or loose stools and burning anus, short yellow urine, red tongue with yellow greasy coating, slippery pulse. Governance clearing away heat and dampness, diuresis and swelling.
Recipe:
Addition and subtraction： Shuchio Yinzi. Plantain, Shiwei, dandelion, Hedyotis diffusa, Alisma each 15 grams, Poria 18 grams, 12 grams each of Qinjie, Daweipi, 10 grams of Sophora flavescens, 6 grams of licorice.
Modification: For those with hematuria, 25 grams of Rhizoma Imperatae root, 15 grams of madder root, and 15 grams of thistle each are added to clear away heat and dampness, cool blood and stop bleeding.
Wet immersion certificate
Main symptoms: Most of the lower extremities are swollen first, then the extremities are swollen gradually, and the lower extremities are more severe. There is no finger when pressed, and it is not easy to recover. Accompanied by chest tightness and abdominal distension, weight drowsiness, less appetite and general malaise, short urination, white and greasy tongue coating, and slow pulse. Governance and invigorating the spleen and removing dampness, Tongyang and diuresis.
Recipe: Wupiyin and Weiling Decoction. Atractylodes, Motherwort, Alisma, Shiwei, Sangbaipi each 5 grams, ginger peel, tangerine peel，10 grams, Polyporus, Poria peel 18 grams, Guizhi 6 grams, 5 jujubes.
Addition and subtraction: If the swelling is even asthmatic, 9 grams of ephedra can be added, and 15 grams of Tinglizi can be added to facilitate asthma.
Syndrome of Yang deficiency and water
Main symptoms: high swelling of the whole body, large abdomen and chest fullness, urge to lie down, cold and tired, pale complexion, poor appetite, lack of urine, pale and fat tongue with tooth marks on the edges, white coating, thin or knotted pulse generation. It is suitable for warming the kidneys and helping the yang, transforming qi and moving water.
Recipe: Yanghe Tang Jiawei. 6 grams each of ephedra, white mustard seeds, licorice, dried ginger, 20 grams of rehmannia glutinosa, 3 grams of cinnamon (separately baked), 12 grams of Cistanche (separately baked), 30 grams of astragalus, and 15 grams of motherwort.
Modification: If heart palpitations, cyanosis of the lips, and stagnation of the pulse are present, then licorice should be changed to 30 grams of licorice root, and 20 of salvia miltiorrhiza should be added to promote blood circulation and relieve palpitation; stew) 10
gram, add 6 grams of Schisandra chinensis, and 20 grams of calcined oysters to nourish qi and fix palpitations.
Spleen deficiency and dampness syndrome
Main symptoms: edema and swelling of the face, repeated ups and downs, abdominal distension, less appetite, pale complexion, mental fatigue, oliguria, clear urine, loose stools, white and slippery tongue coating, and weak pulse. It is suitable for warming and transporting spleen-yang, and diuresis to reduce swelling.
Recipe: Shipiyin addition and subtraction. Astragalus 30 grams, Cistanche 15 Grams, Atractylodes, Motherwort, Alisma, Poria each 15 grams, 6 grams of cinnamon sticks, Dafupi, Guangmuxiang (after the next), Magnolia 12 grams each, Polyporus 18 grams, 5 jujubes.
Addition and subtraction: add 15 grams each of mulberry octopus and golden cherry seed to solidify the essence and qi; for those with low serum protein and persistent edema, add 10 grams of antler gelatin and 12 grams of dodder seed to invigorate the kidney and fill the essence and transform qi. water.
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