Pyelonephritis
[Overview]
Pyelonephritis is inflammation of the renal parenchyma and renal pelvis, most directly by the bacterial infection, often accompanied by lower urinary tract inflammation, clinical sub-acute and chronic two. Main features of low back pain symptoms, urine poured Lek frequency, urgency, dysuria, etc. The disease can occur at all ages, but the most common women of childbearing age. Chronic pyelonephritis is very stubborn, drugs are generally difficult to cure is the cause of chronic renal insufficiency of the important reasons.Pyelonephritis are Chinese “hot shower”, “discredited”, “labor leaching” and other areas.
[Etiology and pathology]
Acute pyelonephritis or acute exacerbation of chronic pyelonephritis stage, dominated the real evil, the performance of one group excess heat syndrome, its cause is overeating Singery Feigan products, too much alcohol, etc., causing hot and humid, the next Note bladder; or for vaginal dirty, dirty cloud of evil from invasive bladder damp heat of the permit; hot and humid Accumulation coke, the gasification block, caused by under Khieu negative urine poured Lek frequency, urgency, dysuria embolism .Chronic pyelonephritis, to being virtual-based, performance is hurt evil love syndrome is due to hot and humid stay for long, injury righteousness, Hao Shang body fluid, leading to kidney yin deficiency, spleen and kidney deficiency, damp, unfinished is empty evil of the card.
[Diagnostic points
1 attack of acute pyelonephritis, the patient often high fever, chills, back pain, abdominal cramps and sometimes there may be; urinary tract symptoms of urinary frequency, urgency, dysuria, urination, urethral burning sensation, voiding difficulty, etc. ; Some patients also experience headaches, nausea, vomiting.
(2) more than half of patients with chronic pyelonephritis acute pyelonephritis past history, symptoms generally not obvious, frequent fatigue, fever, backache, low back pain and other symptoms; accompanied by urinary frequency, urgency, dysuria and other lower urinary tract irritation;
3 Urine examination showed may have bacteriuria.
4. Clean urine culture colony count> 105 / ml of diagnostic significance.
[Dialectical type]
1 acute phase (acute pyelonephritis and acute exacerbation of chronic pyelonephritis) (1) damp symptoms: urine poured Lek frequency, urgency, dysuria, urethral burning sensation, voiding difficulty, or oliguria, lower back pain and refused to press the yellow greasy moss, pulse a few Confucianism or slippery pulse.
Symptoms analysis: heat toxin bet the bladder, gasification blocked, under Khieu negative, so urine poured Lek frequency, urgency, dysuria, urethral burning sensation, urination, oliguria; waist kidney House, under hot and humid force, hurt in the kidney, so the lower back pain refused to press; yellow and greasy fur, slippery pulse pulse number or the number of Confucianism is the signs of heat resistance.
(2) hot Yu Shaoyang symptoms: hot astringent turbid urine, urgency, dysuria, abdominal pain and discomfort, cold and heat exchanges, flank pain, upset accent, quietly not want to diet.
Thin yellow coating, pulse a few strings.
Syndrome analysis: liver veins over the lower abdomen, around the genitals, liver and gallbladder damp, so hot astringent turbid urine, urgency, dysuria, abdominal pain and discomfort; liver failure Shuxie depression of steam heat, made on the Shaoyang,Therefore, heat exchanges, flank pain, upset, bitter mouth, quietly not want to diet; thin yellow coating, pulse a few strings but Shaoyang Yu signs of heat.
(3) heat in the resistance symptoms: chills, fever, particularly at night or afternoon, a small yellow red urinate, urine astringent pain, breath foul and dirty, hospital Fu Man, nausea, hunger does not want to drink, or runny stool or secret, waist pain. Yellow and greasy fur, slippery pulse.
Syndrome analysis: hot and humid in the resistance, heat accumulation in the closed beta, see chills, fever; wet as the Yin Xie, so hot afternoon staggering; heat forced under the bladder, waterways negative, so the small yellow red urinate, urinary astringent when pain; heat resistance in in focus, negative air machine, so the tone dirty muddy, abdominal Fu Man asked.Hunger does not want to drink, abdominal pain; hot colon House, the constipation; gut is forced under hot and humid, loose stools; heat injury in the kidney of adultery, so back pain; yellow and greasy fur, slippery pulse for signs of heat in the resistance gastrointestinal.
(2) chronic phase (chronic pyelonephritis) (1) spleen and two losses symptoms: frequent urination, shower astringent endless, recurrent, even in case Laoyou, accompanied by Oue poor appetite, abdominal distension and boring, aversion to cold , surface floating limb swelling, backache soft knee. White or pale tongue with teeth marks, the pulse was weak.
Syndrome analysis: chronic illness healed, yin and yang deficiency, spleen deficiency, weak bladder gasification, roadway is not solid, waterways poor, so the frequent urination, shower astringent endless, recurrent, even in case Laoyou; the wet spleenresistance Qi stagnation, the Oue poor appetite, abdominal distension, loose stools; g spleen deficiency can not be shipped wet temperature, flooding the skin, so the surface floating limb swelling; kidney yang can not warm the body, it chills; Lumbar kidney House , kidney, then the waist and knees; pale tongue, white, the pulse is weak spleen and loss; tongue side of teeth marks are signs of resistance to dampness.
(2) kidney heat the lag symptoms: frequent urination, urgent, astringent endless pain, good times and hair, even in case Laoyou, accompanied by weakness, sweating, dizziness, tinnitus, weak knees, hands and feet of hot, dry lips. Red tongue, little pain or no fur, with a few thin veins or fine.
Syndrome analysis: Kidney water and fire of the house, the root element yin yang, evil heat stay for long, leading to loss of kidney Yin, resulting in vaporization of bladder weakness, coupled with damp nostalgia, waterways negative, so frequent urination, urgent, astringent endless pain , good times and hair, even in case Laoyou; Khan Yin Ye, kidney deficiency, so the fatigue sweating; deficiency is lack of marrow, brain loss of support, so the tinnitus; kidney shortage is weak waist; Yin virtual heat, the hands and feet of hot, dry lips; red tongue, little pain or no fur, pulse is thin with few or signs of kidney Qi and Yin Deficiency.
[And Treatment]
1 acute phase (1) damp treatment: heat dampness Tonglin.
Recipe: eight subtraction are scattered.
Sharp build 9 g Qu Mai 9 g Plantago 30 grams (including fry) Akebia 6 g talc 30 g Gardenia 9 grams 9 grams of rhubarb rush 3 grams of licorice shoot 3 g subtraction with the disease: fever worse, plus honeysuckle 9 grams, forsythia 9 grams, 30 grams of dandelion to strengthen the power of heat; lower abdomen bulge pain who Kagawa?? sub 9 grams, 9 grams aggregata to qi; hematuria, increase habitat charcoal 12 grams, Chine 30 grams, to stop bleeding in urine; oliguria, Gase diarrhea 15 grams, Polyporus, Poria 12 grams each, to facilitate water Shenshi.
(2) hot Yu Shaoyang Therapeutic: Liver gallbladder Tonglin.
Recipe: Xiao Chai Hu Tang Long Dan Xie Gan Decoction.
Bupleurum gentian 6 g 9 g 9 g Scutellaria Plantago Gardenia 9 grams to 30 grams (including fry) Akebia Alisma 12 g 3 g talc 30 g habitat 15 grams Angelica 9 grams of licorice shoot 3 grams.
Subtraction with the disease: very hypochondriac pain, plus fumarate 9 grams, Sichuan?? Sub 9 grams, the liver qi; I suffer constipation, plus 9 grams of rhubarb to purge heat; dysuria than those who play, plus Treats 9 grams, Commelina 15 grams, 30 grams of dandelion, the clearing under the coke heat.
(3) in the resistance heat treatment: heat dampness Tonglin.
Recipe: Three red lead Ren Tang Cheng Qi Decoction.
Almond 9 grams bamboo 6 g 6 g Ban Xia Bai Kou Ren Magnolia 9 g 9 g 15 g talc 30 g Yiyiren Akebia 3 g white through the grass 6 g Plantago 15 grams (including fry) habitat, 15 g 9 g Scutellaria Coptis 3 g Cork 9 grams of licorice shoot 3 grams subtraction with the disease: constipation, plus 9 grams of rhubarb to purge purging fire; loose stools, plus 15 grams of yam, Poria 15 grams, to the spleen to stop diarrhea;
Fu Man who asked the hospital, plus citrus aurantium 12 grams, 6 grams of dried tangerine peel to qi.
(2) chronic phase (1), spleen deficiency rule is: the spleen and kidney, clearing away heat.
Recipe: SHENLINGBAISHU Powder Zhibai Dihuang addition and subtraction.
Codonopsis 12 grams 12 grams Atractylodes Yiyiren white lentils 15 g 15 g 15 g yam medicine Zhimu 9 grams Treats 9 grams habitat 9 Keze diarrhea 15 g Poria 12 g talc 30 g Amomum 3 grams dried tangerine peel 6 grams subtraction with the disease : Oue poor appetite who, basil 9 g, Pinellia 9 grams, 6 grams of Gallus gallus domesticus, to Huazhuo Jiangni appetizer; aversion to cold, plus Epimedium 12 grams, Curculigo 12 grams, the temperature kidney dispelling; surface floating limb swelling, plus psyllium 15 g (including fried), Tai Fupi 12 grams, to facilitate the withdrawal of water swollen; the urine more than Lek, plus treating diabetes 9 g, dodder 9 grams, the kidney Guse.
(2) kidney heat the lag rule is: Yin and kidney dampness Recipe: Zuoguiwan flavored.
Habitat turtle version 9 g 15 g 9 g Treats 9 grams Zhimu dogwood 9 grams 30 grams of astragalus Codonopsis 12 grams 12 grams yam medlar Achyranthes 9 g 9 g 12 g antler Cuscuta 12 Keze diarrhea 9 g Poria 12 grams of licorice shoot 6 grams subtraction with the disease: tinnitus, plus Tianma, chrysanthemum 9 grams, 12 grams of Ur, Abalone shell 30 grams to Pinggan; urination pain evident, plus sharp build, Dianthus superbus 9 grams, Plantago 15 grams of coke to heat the next clearing.
[Chinese medicine]
1. Chuanhuning injection per 20 ml, day 1, intravenous infusion.
2. Zuoguiwan each 4.5 grams, 2 times a day, orally.
3 to 4 capsules each time, 3 times a day, orally.
[Side] is simple
1 article build, Huomai, Andrographis paniculata, Commelina, 15 grams, Shuijianbi 1.
2 celery 250 grams of fresh, raw licorice 10 g, add boiling soup, day 1.
3 50 grams Chixiaodou add Shuizhu Shu, and then into 15 g Gallus gallus fine, mixing food, day 1.
[] Other therapies
Acupuncture: Point Selection Shenshu Sanyinjiao, Guan Yuan, flying, double slide, back, reinforcing-reducing; with ear kidney area, bladder, adrenal gland, etc.; every other day, 10 day cycle.
Diet:
(1) green bean sprouts 250 grams, add spices fry food.
(2) Kalimeris 500 grams, chopped, salt, MSG, sesame oil and mix well epigenetic consumption.
(3) raw lotus root 500 grams, sugar 500 grams, 500 grams of fresh water chestnuts are Jiaozhi; mixed drink, day 1.
(4) turtle one of about 250 grams, plus the amount of onions, ginger, rice wine, salt and other steamed food.
Taking sodium bicarbonate, each 1 gram 3 times a day, can be alkaline urine, to reduce bladder irritation.
Best in the urine bacterial culture and drug sensitivity test carried out under the anti-infective treatment.
PRECAUTIONS
1 acute phase to active treatment to relieve symptoms and prevent recurrence.
Encourage patients to drink more water, more than two liters a day to increase urine output, flush out the bladder, urethra of bacteria. Actively find and remove the inflammatory lesions, attention during pregnancy, postpartum, and menstrual hygiene, keep the stool.
(2) and acute pyelonephritis in patients with acute exacerbation of chronic pyelonephritis not eat greasy, hot, spicy foods, fasting tobacco and alcohol. Heat diuretic should eat foods, such as melon, green bean sprouts, mustard, Malan top; Yichi light, water-rich foods such as vegetables, fruit.
Patients with chronic pyelonephritis should be appropriately tonic, but not nourishing yang, Yin Ching should be eating turtle, turtles, ducks, white fungus, lily, water chestnut and so on.
3 acute pyelonephritis timely treatment, cure, the prognosis is good.
Stubborn refractory chronic pyelonephritis, chronic renal failure leading to important reasons, such as chronic renal insufficiency, the prognosis is poor.