Renal tuberculosis
[Overview]
Renal tuberculosis is Mycobacterium tuberculosis infection from the lungs or other parts of the hematogenous spread of tuberculosis to the kidneys, the gradual destruction of renal parenchyma, causing the kidney cortex and medulla lesions, and can involve the ureter, bladder and urethra, and even reproductivesystem (prostate, seminal vesicles, vas deferens, epididymis, and pelvic and other organizations), the Department of a simultaneous destruction and restoration of a chronic disease. The main symptoms features are fever, fatigue, back pain, urinary frequency, urgency, dysuria, hematuria. More common in young adults aged 20 to 40, more men than women, male to female ratio of 2:1. Renal tuberculosis belongs to Chinese medicine “kidney TB”, “virtual TB”, “internal heat”, “discredited”, “back pain” and other areas.
[Etiology and pathology]
The pathogenesis in the kidney, and lung, spleen, liver, kidney, bladder and other organs related. Cause of violation of insects rubbing, pass through the lungs directly into the kidney or kidney walls. Son of the lung kidney, lung and kidney appeared with the disease, Yin loss; kidney and bladder relative to the table, so see frequent urination, urgency, dysuria and other urinary bladder damp heat syndrome;
B Kuei-homologous, lack of liver and kidney yin deficiency, Yin Huo-wang; to late can also lead to spleen deficiency, qi stagnation and so on.
[Diagnostic points
1 Clinical symptoms of irregular fever, night sweats, fatigue, lethargy, loss of appetite, irritability, insomnia; Mycobacterium tuberculosis to stimulate the bladder mucosa caused by urinary frequency, urgency, dysuria, hematuria and other symptoms; pyuria stimulate the urethra can cause local burning sensation, kidney pain, pain is usually dull or cramping nature.
2 When the formation of a large number of renal fibrosis or calcification of empyema, the waist palpable mass.
3 Urine and urine laboratory tests to identify Mycobacterium tuberculosis, the key to the diagnosis of the disease. Serious or even see the urine samples were washed in water, and contain debris.
4. Tuberculin test will also help diagnosis.
[Dialectical type]
1 lung and kidney symptoms: cough, shortness Kesheng, less red sputum or bloody sputum, hematuria, dysuria, back pain, dry mouth and throat, hands and feet of fever, night sweats. Red tongue, little breakdown pulse.
Signs Analysis: Yin deficiency, Xuan Su disorders, so cough, Ke Sheng short, less sputum; deficiency heat, damage lungs network, visible red blood in the sputum; heat forced under the coke burns collaterals, the hematuria, dysuria . Kidney yin deficiency, the raw heat, heat forced sweating, dry mouth and throat and therefore, hands and feet of fever, night sweats; back to the House of kidney, yin deficiency, it is low back pain; little red tongue, rapid pulse is negative virtual heat of the elephant.
2 damp symptoms: a few short urination frequency, urgency, burning, tingling, hematuria or pyuria, Shaofu Juji pain, swelling and pain in the waist. Yellow greasy moss, pulse a few or slide.
Syndromes: damp, gasification bladder disorders, it is short a few frequent urination, urgency, burning, tingling, Shaofu Juji pain, swelling and pain in the waist;
Heat hurt the blood network, then see hematuria; Damp drugs, then see pyuria; yellow greasy moss, pulse a few or a few slip but heat resistance of the levy.
3 liver and kidney symptoms: dizziness head Shibuya, blurred vision, hot flashes afternoon, zygomatic red, five upset hot, sweating, scanty dark urine, blood, body weight, waist and knee pain, numbness, tinnitus, women’s menstrual tone, loss of fine men’s dreams. Little red tongue or yellow fur, rapid pulse.
Syndrome analysis: liver reinforcement, opens into the eyes, liver, then the head Shibuya dizziness, blurred vision; deficiency heat, so hot flashes, zygomatic red, five upset hot, sweating; forced under the hot coke, damage the blood network, the scanty dark urine, blood; liver and kidney B Kuei-homologous, back to the House of kidney, liver and kidney, the body weight, waist and knee weakness, numbness, tinnitus, women, irregular menstruation, loss of fine men’s dreams; red, little yellow moss or moss, pulse breakdown is insufficient liver and kidney Yin Huo-wang of the elephant.
4 spleen deficiency symptoms: oliguria, urine retention or urinary incontinence, backache or pain, abdominal distention after eating, nausea and vomiting, the less satisfied boring, Shenpi fatigue, heavy limbs not warm, or the mouth of the urine smell, lookingchlorosis. Pale tongue, white, thin weak pulse.
Syndrome analysis: spleen deficiency, gas is not of water, the bladder opening and closing negative, so oliguria, urine retention or urinary incontinence; deficiency, the backache or pain; card lost health movement, cold cohesion, gas -poor, so Shenpi fatigue, heavy limbs not warm, abdominal distention after eating, nausea and vomiting, less satisfied pond; renal adverse tiger gasification, wet cohesion, so the mouth of the urine smell; pale complexion, pale tongue, white, weak pulse are signs of deficiency for the spleen.
5. Qi stagnation symptoms: lower back tingling or pain, aggravated at night, oliguria and frequency, dysuria, hematuria.Dark tongue or mouth ecchymosis, the pulse is very tight astringent stagnation.
Syndrome analysis: early disease in the gas in the classics, people sick for a long time into the network of blood, blood is negative, the night is cloudy, the blood stasis, not pain, tingling or so back pain, aggravated at night; blood stasis kidney, gasification negative, then the oliguria and frequency; stagnation, while dysuria, hematuria; mouth tongue dark or ecchymosis, is astringent pulse delay are very tight blood stasis of the levy.
[And Treatment]
1 treatment of lung and kidney are: moist lung and kidney, nourishing yin and stop bleeding.
Recipe: Lily solid Kanemaru combined decoction of Artemisia annua turtle.
Lily Winter oats 9 9 g 9 g Scrophulariaceae from Shao habitat 9 g 9 g 9 g Campanulaceae 6 Kebei mother turtle Zhimu 9 g 9 g 9 Kedan Pi annua grass Daji 12 g 12 g 30 g Rhizoma Imperatae one hundred nine grams of licorice tip 6 grams subtraction with the disease: hemoptysis, hematuria worse, plus white and 9 grams, thistle grass 12 grams, to stop bleeding in urine; urination pain, plus articles build 9 grams, Zhai wheat 9 grams, the clearing under the coke heat.
2 damp rule is: clearing the bladder, dampness detoxification.
Recipe: Eight is San Daochi Powder flavored.
Sharp build 9 g Qu Mai 9 g Plantago 15 grams (including fried) 30 g Talc 6 g Mu Tong bamboo 6 grams Treats 9 grams Anemarrhena 9 g habitat 15 grams one hundred nine grams of licorice tip 6 grams subtraction with the disease: Very low back pain, plus Achyranthes 9 grams, 12 grams Loranthaceae, to kidney Zhuangyao; hematuria, increase thistle, thistle grass, madder each 12 grams of carbon to stop hematuria.
3 Therapeutic liver and kidney: liver and kidney tonic, Yin Jiang Huo.
Recipe: Yiguangjian together Dabuyin Pill.
Habitat, winter oats 12 Kashagan Ref 9 9 g 9 g medlar turtle turtle version of 15 g 15 g angelica 9 Kechuan?? Sub 9 g 9 g Treats 9 grams Zhimu one hundred nine grams subtraction with the disease: vertigo even , plus Gastrodia 9 grams, to Pinggan; head paste, add chrysanthemums, blue suitcase with 9 grams to Liver eyesight; tinnitus, plus Shichangpu 12 grams, 30 grams spiritual magnet to open kidney ear orifices; those bloody urine, increased thistle, thistle grass 12 grams, to heat to stop bleeding.
4 spleen deficiency rule is: Spleen Qi, Warming Xiezhuo.
Recipe: Bu Zhong Yi Qi Tang and Ji Sheng Shen Qi Pill.
Aconite 6 grams of cinnamon 9 grams 30 grams of astragalus Codonopsis 12 grams 12 grams Atractylodes yam 15 grams Rehmannia 15 g Achyranthes Plantago Angelica 9 grams 9 grams 15 grams (including fry) Alisma 15 g Poria 12 grams one hundred 15 grams dried tangerine peel 6 grams subtraction with the disease: urinary incontinence, plus Rosa laevigata, Sang Shenzi of 9 grams to kidney Guse; nausea, vomiting, mouth, urine smell, plus berberine 6 grams, Evodia 3 grams, to Acrid bitter drop ; pay less, plus Gallus gallus domesticus 6 grams, 9 grams Divine Comedy to digestion; loose stools, plus Yiyiren 15 grams, 9 grams of white beans to the spleen to stop diarrhea.
5. Qi stagnation rule is: blood circulation, gas Tongmai.
Recipe: Aquilaria Powder-generation arrival of the Nine addition and subtraction.
Citrus sinensis 3 g 9 g 6 Kewu drug citrus aurantium 12 g peach kernel 9 grams saffron 3 g Radix Angelica 9 g 9 g 12 g pangolin Vaccaria 9 g 9 g Shi Wei Dong Kuizi 12 g talc 30 g with Modified disease: low back pain tingling or who Gadou Zhong, Achyranthes 9 grams, 12 grams Loranthaceae, to kidney Zhuangyao; hematuria, plus 37 powder, 3 grams daily, with only hematuria.
[Chinese medicine]
1 Department of Qin Dan tablets every 5, 2 times a day.
2. Liuweidihuangwan each 4.5 grams, 2 times a day.
3. Dabuyin pill every 4.5 grams, 2 times a day.
[Side] is simple
1. One hundred 12 grams, Dan 9 grams, 18 grams of raw land, Rehmannia 18 grams, 15 grams arrested concubine, Sunburn turtle 30 grams, 30 grams glutinous rice root, decoction, day one.
2. Lily 20 grams, 10 grams of Radix, a total of fried juice, and then with 100 grams of rice porridge eaten.
3. Xianou 500 g smashed juice, stir, steamed yam 500 g peeled and smashed into the mud, mixing the two after eating.
[] Other therapies
Acupuncture: Point Selection tuberculosis, Shenshu, bladder Yu, Yu blind cream, the full three years, the sea air, Guan Yuan, reinforcing-reducing, every other day, 15 days for a course of treatment.
Diet:
(1) live turtle one, add spices, steamed food.
(2) light duck one, the 10 grams of Cordyceps, duck into the abdomen, add spices steamed 2 hours, eat duck soup.
(3) 300 grams of fresh shepherd’s purse, chopped, add boiling water, that is, into 300 g tofu, add spices thicken into a shepherd’s purse tofu soup.
(4) 250g clam meat slices, 250 g leeks and cut into sections, add boiling water, add spices and simmer gently through the turn after eating.
Unilateral advanced renal tuberculosis may consider surgery.
PRECAUTIONS
1 of pulmonary tuberculosis or tuberculosis of the other patients, the urine should be checked, the early detection of renal tuberculosis and early treatment. Note rest and emotional adaptation.
2 patients with renal tuberculosis to add high-calorie and high-quality protein, and the need milk; require a lot of vitamin A, B, C, D; more fresh vegetables, fruits and a variety of light foods rich in water, in order to maintain urine smooth, enhanced diuresis.Jiubingtixu patients should eat tonics.
Avoid hot, fragrant dry diet, also avoid alcohol and tobacco.
3, such as renal tuberculosis, early diagnosis, proper treatment of active, can be cured; If it is found too late, has been severely damaged kidney or ureteral stricture, may require surgical treatment, the prognosis is poor.