Chronic nephritis is and allergic disease caused by a wide
variety of etiological factors. Only a small percentage of cases
are obviously due to the progression of acute nephritis. The
majority of patients with chronic nephritis have no history of
acute nephritis. The disease is common in young adults and
middle aged people. Its course is long and the prognosis is
unfavorable. In TCM, this disease is categorized as "shui zhong"
(edema), "xu lao " (consumptive diseases), "yao tong" (lumbago),
etc.
Main
Points of Diagnosis
There are three types of chronic nephritis
according to the clinical features.
1. Common type: The course of this type is persistent. The
quantitative examination of urinary protein is at a range
between 1.5g and 3.5g per day. Patients may have hypertension,
hematuria, cylinduria and decrease of renal function.
2. Nephrotic type: In addition to the features of the common
type, quantitative examination of urinary protein is greater
than 3.5g per day, the serum albumin is less than 3.5g percent.
Marked edema is the characteristic feature of this type.
3. Hypertensive type: A persistent hypertension is the
predominant manifestation of this type of chronic nephritis
besides the features of the common type.
Differentiation and Treatment of Common Syndromes
1. Deficiency of the Spleen-Yang and Kidney-Yang
Main Symptoms and Signs: Pale complexion, lassitude,
listlessness, aversion to cold, cold limbs, high-grade edema,
abdominal distension, anorexia, soreness of the waist, oliguria,
thin and whitish coating of the tongue, deep and fine pulse.
Therapeutic Principle: Warming yang of the spleen and kidney to
promote diuresis
Recipe: Modified Decoction for Reinforcing the Spleen.
astragalus root
codonopsis root
white atractylodes rhizome
poria
prepared aconite root
cinnamon bark
shell of areca husk
water-plantain tuber
plantago seed (wrapped in a piece of cloth before decoction)
All the above herbs re to be decocted in water for oral
administration.
If the edema is mile but persistent, it suggests the deficiency
of spleen-qi, the treatment should be aimed at replenishing qi
and invigorating the spleen to induce diuresis. Modified
Tetrandra and Astragalus Decoction is preferred for the
treatment. The compositions are: tetrandra root 10g, astragalus
root 15g, white atractylodes rhizome 15g, codonopsis root 15g,
poria 15g, umbellate pore-fungus 12g, water-plantain tuber 12g,
tangerine peel 10g, prepared licorice root 3g. All the above
herbs are to be decocted in water for oral administration.
2. Hyperactivity of Yang due to Deficiency of Yin
Main Symptoms and Signs: Indistinct edema, headache, dizziness,
tinnitus, dry mouth, irritability, feverish sensation in the
palms and soles, palpitation, insomnia, red tongue, taut and
thready pulse.
Therapeutic Principle: Nourishing yin and suppressing
hyperactive yang.
Recipe: Bolus of Six Ingredients Including Rehmannia and Adding
Wolfberry and Chrysanthemum with additional ingredients.
wolfberry fruit
chrysanthemum flower
fresh rehmannia root
prepared rehmannia root
dogwood fruit
moutan bark
Chinese yam
poria
water-plantain tuber
tortoise plastron
uncaria stem with hooks
eucommia bark
abalone shell
All the above ingredients are to be decocted in water for oral
administration.
3. Retention of Damp-Heat in the Body
Main Symptoms and Signs: Flushed face, obesity, edema,
distension of head, headache, dry mouth, irritability,
constipation, prolonged hormonotherapy, thin and yellowish or
yellowish and greasy coating of the tongue, taut and rapid or
slippery and rapid pulse.
Therapeutic Principle: Clearing away pathogenic heat and
dampness.
Recipe: Modified Decoction of Gentian for Purging Liver-Fire.
gentian root
scutellaria root
capejasmine fruit
water-plantain tuber
plantago seed (wrapped in a piece of cloth during decocting)
dried rehmannia root
phellodendron bark
dandelion
cogongrass rhizome
All the above herbs are to be decocted in water for oral
administration.
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