Chronic glomerulonephritis
[Overview]
Chronic glomerulonephritis referred to as chronic nephritis, which is a common autoimmune diseases of urinary system.Chronic nephritis is caused by a variety of different pathological types of bilateral diffuse or focal glomerular inflammatory changes; is a group of similar clinical manifestations and pathological changes vary, the primary outcome is different in the kidney ball disease in general. The main symptoms characteristic edema, proteinuria, hematuria, hypertension and renal insufficiency.
The majority of patients the slow onset, often chronic progressive course, from a small number of changes by acute nephritis. As the disease progresses, patients with more than 2 to 3 years or 20 to 30 years after renal failure. In end-stage chronic renal failure caused by a variety of causes of chronic nephritis occupy the first place. Chronic nephritis is a traditional Chinese medicine “edema”, “cloudy water”, “back pain”, “Consumption” and other areas.
[Etiology and pathology]
The disease is mainly related to the lung, spleen, liver, kidney and other organs dysfunction related to lung deficiency is of essence and of the gas is not water, then the soil is not water deficiency and water pan, kidney is the main water nothing and Wang Xing, resulting in fine body of water distribution and gasification dysfunction, stay wet or overflows. Yin Yang damage and disease for a long time, also loss of kidney yin.
Long-yin deficiency, water is not Han wood, the liver and kidney, liver yang syndrome. Qi and Yin deficiency, blood whom blocked, showing stasis of the disease. The disease eventually leading to yin and yang, spleen and kidney decline, overcast cloud filled the critical syndromes.
[Diagnostic points
1 slow onset, persistent disease, clinical manifestations of proteinuria, hematuria or microscopic examination of urine red blood cells, edema, hypertension, renal insufficiency, duration of more than 1 year, excluding secondary renal disease, kidney disease and other infectious chronic kidney disease, the disease can be considered. Because of its longer duration of chronic nephritis, and some even up to several decades. Because renal unit gradually undermined, so often appear late renal atrophy, renal failure.
2 Based on the clinical manifestations can be further divided into the following five types of common type: mild or moderate edema; may be associated with moderately elevated blood pressure; urine tests may have moderate proteinuria (+~++), urinary sedimentoften more than 10 red blood cells / high power field, and have varying degrees of control of urine; often have some degree of renal damage, creatinine clearance rate, nocturia, urinary function decreased concentration, decreased urine osmolality, urine specific gravity (relative density) of less than 1.015, azotemia; most patients were fatigue, anorexia, backache, anemia.
Type of hypertension: a common type of performance, but sustained blood pressure, elevated above the middle level (especially diastolic pressure) is characterized by;
Edema and urine tests changing the light; renal function and more moderate or even severe damage; fundus examination, common retinal artery were thin, tortuous, reflective vein enhancement and the phenomenon of cross-indentation and flocculent exudate.
Kidney type: moderate edema, proteinuria, hypoalbuminemia, hyperlipidemia may have. May be associated with varying degrees of hypertension, hematuria, anemia, renal insufficiency performance.
Mixed: while with the above three types of clinical characteristics.
Acute: often from respiratory infections and other reasons induced, acute onset; edema, blood pressure, may have gross hematuria, urinary protein (+ ~ 10 Shi Shi) range, can be a tube; by rest and symptomatic remission after treatment can also be self-ease, ease after leaving varying degrees of renal dysfunction and anemia in performance.
3 renal puncture biopsy can help confirm the diagnosis.
[Dialectical type]
1 lung and kidney deficiency, moisture remaining symptoms: pale complexion once see swelling, edema, mild, persistent fever, less weakly, colds, lumbar pain. Pale tongue, thin white run, with teeth marks, weak pulse.
Syndrome analysis: lung declared fat to water passage, lung failure Xuan Su, water and gas block and meet the Department of edema; guard outside the cold air is not solid is easy; kidney water liquid to water, gas lines, kidney failure Yang, refined gas is not sufficient to meet the color and complexion, less weakly, lumbar pain; pale tongue, thin white run, with teeth marks, weak pulse, as lung and kidney qi deficiency, signs of moisture inside the stagnation.
2. Spleen deficiency, moisture spread symptoms: the whole body was swollen, may be associated with pleural effusion, ascites, abdominal distension, oliguria, pale? S white, aversion to cold, Shenpi fatigue, nocturnal emission impotence or menstrual disorders, lumbar pain or tibia acid petrified, poor appetite, or loose stools. Pale tongue, teeth marks, thin greasy moss, pulse was thin or weak, Shen Chi.
Syndrome analysis: people lose liquid water transport and distribution depends on the temper, kidney transpiration. Loss of spleen yang deficiency is deposited on the fabric, moisture inside the stop so the whole body was swollen, may be associated with pleural effusion, ascites, abdominal distension, oliguria; spleen deficiency is loss of limbs in the warmth, waist loss of support, so the white gaze intently looking , aversion to cold, Shenpi fatigue, lumbar pain or shin Tuiruan; yang temperature of not less than ice-gas, health movement disorders, wet muddy not leak, so the cohesion is poor appetite or loose stools; kidney then the fine is not solid, then see off nocturnal emission impotence or menstrual disorders; tongue pale, with teeth marks, thin greasy moss, pulse, or are unable to sink late spleen deficiency, signs of moisture spread.
3 liver and kidney yin deficiency, the more virtual yang symptoms: dizziness, headache, five upset hot face hot flashes, tinnitus, dry eyes or blurred vision, head, mouth and throat, lumbar pain, nocturnal emissions, menstrual disorders, urinary astringent short , or a slight swelling, poor stool. Red tongue, little coating, wiry pulse, or breakdown.
Syndrome analysis: liver opens into the eyes, kidney opens into the ear, liver and kidney, liver yang are dizziness, headache, tinnitus, dry eyes or blurred vision head; Yin hot, so see five upset hot, the surface wave Red, dry mouth and throat;
Kidney essence deficiency, the lumbar pain, nocturnal emission, menstruation disorders; liver and kidney yin deficiency, the urine short Shibuya, poor stool; kidney gasification and therefore there was a slight swelling; red tongue, little hard, wiry pulse, or breakdown of signs of liver and kidney.
4. Qiyinliangxu, bleeding resistance symptoms: pale minimalist or dark complexion dark, weak or less easy to cold air, hot afternoon fever or dysphoria, dry mouth and throat or long-term sore throat. Reddish tongue, little coating, pulse or breakdown or astringent.
Syndrome analysis: consumption of gas long illness, Yin and also loss, blood whom the block, then meet minimalist or dark complexion dark color; Qi is weak or less easy to cold air; Yin is the afternoon fever or dysphoria hot, dry mouth sore throat or long-term; Qi and Yin deficiency, Hot endogenous pain is less reddish tongue, pulse or breakdown; poor blood and pulse astringent.
5. Splenorenal decay, dampness Yun Sheng symptoms: dark complexion and swollen stagnation, mental Weidun, body weight loss, chest tightness, abdominal distension, poor appetite, anorexia, nausea, vomiting, oliguria or urine long, diarrhea or constipation, and even then the noise disturbance, restlessness, coma and convulsions. Tongue pale, thin greasy or sallow and greasy thin or thin string.
Syndrome analysis: strength very empty, spleen and decay, wet and dirty connotation, so the dark complexion and swollen stagnation, mental Weidun, emaciation; cloud overcast, do not drop the chest, abdominal distension, poor appetite, anorexia, nausea and vomiting; renal adverse off the oliguria or urine long; Spleen transportation right to the diarrhea or constipation; wet muddy noise interference on the interference is empty restless, coma convulsions; tongue pale, thin greasy or sallow and greasy thin or spleen and kidney thin string decay, wet cloud filled the like.
[And Treatment]
1 lung and kidney deficiency, moisture stay rule is: make double-lung and kidney, Qi and Water.
Recipe: Yu Ping Feng San Menispermaceae Astragalus Decoction.
Astragalus 30 grams 12 grams Atractylodes Polyporus wind 9 g 12 g 12 g Poria 12 Keze diarrhea Chen hoist 12 grams Motherwort 15 Keze Lan leaves 15 grams of white silkworm 9 grams 6 grams 6 grams of licorice oneself subtraction with the disease: fatigueworse, plus Codonopsis 12 grams, 9 grams of Polygonatum to qi; backache worse, Ghassan parasitic 12 grams, Eucommia 9 grams, Woodwardia 9 grams, the kidney strong waist.
2. Spleen deficiency, moisture spread rule is: Warming warm the spleen, of gas Lee water.
Recipe: Zhen Wu Tang decoction real spleen. Aconite 6 g 9 g dried ginger grass fruit 9 g 12 grams Atractylodes Poria 15 g Plantago 30 grams (including fry) 15 grams Alismataceae Da Fupi 12 grams 9 grams of papaya wood 6 g Magnolia 9 grams 6 grams of licorice.
Subtraction with the disease: fatigue will be boring, plus 15 grams of astragalus, Codonopsis 12 grams, 15 grams of yam, Yiyiren 15 grams, the Qi and spleen; abdominal distension, oliguria, plus Chen gourd 9 grams, to eliminate the diureticswelling; a pleural effusion, ascites, plus 9 grams of ugly black and white, pepper Head 3 grams Tinglizi 12 grams, Morus alba 12 grams, to capture by water.
3 liver and kidney yin, more yang virtual Therapeutic: liver and kidney tonic, Yin and Yang.
Recipe: Zuoguiyin subtraction habitat 15 grams medlar turtle version 9 g 9 g 9 g Cornus 15 grams of yam, Poria 12 Ke Ze Xie Dong Kuizi 9 g 12 g 30 g spiritual mother of pearl magnet 30 grams 6 grams of licorice with the disease Modified: urination disadvantaged, add plantain, Rhizoma Imperatae 30 grams, articles build 9 grams, 15 grams of Smilax glabra, the heat and dampness; if backache nocturnal emissions, plus Rosa laevigata 9 grams of solid fluorescent 9 grams, the kidney Guse;
Tinnitus worse, plus Shichangpu 12 grams, to facilitate ear orifices.
4. Qiyinliangxu, bleeding resistance treatment: Qi Yin, clearing heat and blood circulation.
Recipe: Shenqidihuang Decoction.
15 grams of astragalus is too raw in reference 15 g habitat dogwood 9 g 9 g 9 g Ligustrum 9 Kedan Pi Poria 12 grams yam 15 Keze diarrhea 15 Kdan reference Motherwort 15 g 15 g 6 g cicada white silkworm 9 g Zhigancao 6 grams subtraction with the disease: colds, plus 12 grams Atractylodes, wind 9 grams, to Qi solid form; afternoon fever or dysphoria hot, add the turtle version of 9 grams, 12 grams Digupi to Yin heat; long sore throat, plus Shegan 9 grams, 9 grams tonkinensis to heat Liyan; such as bleeding resistance were evident, plus Curcuma 9 grams, 9 grams leech to blood stasis.
5. Splenorenal decay, dampness Yun Sheng rule is: make yuan righting, detoxification reduce turbidity.
Recipe: Zhen Wu Tang Six Gentlemen Decoction.
Codonopsis 12 grams 12 grams Atractylodes Pinellia 9 g Poria 12 g ginger, orange peel skin 9 g 6 g 6 g Aconite 6 to 9 grams of rhubarb Coptis 6 g Plantago 15 grams (including fry) Alisma 15 grams 6 grams of licorice with Modified disease: nausea and vomiting, plus Zhuru 9 grams, to Jiangni;
Coma, soda in Hong nine to aromatic resuscitation; irritability, convulsions, plus Scorpion 6 grams of Uncaria 9 grams, 30 grams abalone to Pingganxifeng.
[Chinese medicine]
1. Nephritis four tablets every four flavor, 3 times a day.
2 Bailing capsule every four, three times a day.
3. Tripterygium wilfordii tablets dosage per kilogram of body weight per day from 1 to 1.5 mg, 3 times a day service.
4. KMSHT 2 tablets 3 times a day.
[Side] is simple
1 Corn 60 grams, 30 grams Bodhisattva, verbena 60 grams, decoction.
2 seeds 250 g cooked crisp, brown sugar 50 grams, mixed with 5 g tea drinking.
3 green beans 30 grams, the system tuber 30 grams, water to cook beans cooked food.
[] Other therapies
Acupuncture: Point Selection Shenshu, water, air sea, triple burner Yu, Sanyinjiao so, once a day l day course of treatment.Spleen Wenshen, benefits of water swelling power.
Diet:
(1) every morning, fresh goat’s milk or edible eggs 1 500g.
(2) 30 grams of yam, rice amount, add water Zhu Chengyu, plus the amount of sugar clothing.
(3) broiler 1, Astragalus 120 grams, add water into the casserole stew Sulan, the chicken soup.
(4) l of the snakehead, melon 500 g (peeled), along with soup, no salt.
(5), a fried soft-shelled turtle (add a little sugar) consumption.
PRECAUTIONS
1. In a timely manner to prevent and treat acute nephritis, avoid strenuous labor, by the cold wet, to prevent infection, and to avoid the application of kidney damage, drugs, prevention of this disease has important implications.
(2) the slow course of chronic nephritis, drug treatment ineffective. After a period of dietary treatment, eating nourishing food, can in remission, renal function can be restored. If elevated blood cholesterol, fat intake should be controlled. Edema and hypertension, should be low-salt diet. Anemia, should be more than to add iron, vitamin B, c and more food. Patients have high blood pressure, should eat light food, avoid moving the wind of the goods, eat or not eat spicy, spicy food or seafood and strong.
Blood urea nitrogen is not high and there is edema, should be high-protein diet; elevated blood urea nitrogen, to a low protein diet.
3 Most of the patients in active treatment, can be a long time to maintain good kidney function.