Acupuncture Houston Ph.D Blog

[Overview]
Nephrotic syndrome is a broad variety of causes of glomerular disease a clinical syndrome group. The etiology and pathogenesis has not yet fully understood, the main pathophysiological changes are glomerular filtration membrane permeability of plasma albumin.The main symptoms are features of massive proteinuria, hypoalbuminemia, hyperlipidemia, and varying degrees of edema.Nephrotic syndrome classification of primary and secondary two:
Primary refers to diseases caused by primary glomerular; secondary is secondary to other diseases or those caused by a specific etiology. Nephrotic syndrome can be divided into type Ⅰ and Ⅱ. Where no persistent hypertension, urinary red blood cells centrifuged <10 / high power field, no anemia, no persistent renal insufficiency, urinary protein highly selective, C3 were within the normal range for the type Ⅰ, type Ⅱ vice versa. The disease in children with glomerular diseases account for 70% to 90% in adults also accounted for 20% to 30%. Nephrotic syndrome belongs to Chinese medicine, "edema," "urine," "back pain", "Consumption" and other areas. [Etiology and pathology] The disease external wind, moisture, heat, drugs, workers want and so on. Internal factors mainly the lungs, spleen, kidney and other organs triple burner lose water distribution refined dysfunction. The basic pathology is edema: the standard in the lung, the system in the spleen, the present in the kidney. If the evils attack the lungs, lung failure Xuan Su, not water passage; or spleen is not health movement, not of water, grain, moisture inside the stop; or kidney deficiency, opening and closing loss Secretary, can lead to edema. If the moisture overflows, deter yang; or Yang ferrite people who can see the spleen deficiency. If edema course of time, friction Yinxue, showing liver and kidney. Flow and blood diseases and chronic illness into the network, and visible water stasis in each node of the card. If the lesions involving multiple organs, often the yin and yang do not fall in love, so that the decline in Yuanyang, really yin depletion, toxic cloud to be filled, then the condition Wei Du. [Diagnostic points 1 edema. (2) and 24-hour urine protein in urine proteinuria more than ten qualitative - Shi Shi Shi Shi Shi Shi; quantitative> 3.5 g / 24 hours; Ⅱ nephrotic syndrome or microscopic hematuria can be found in red blood cells (urine sediment microscopy> 10 red blood cells / high power field).
3. A great part of the plasma protein showed hypoalbuminemia.
4. Lipids in plasma cholesterol, triglycerides (triglycerides) were significantly increased; low-density and very low density lipoprotein concentration; normal or slightly high-density lipoprotein decreased.
5 most normal renal function renal function; nephrotic syndrome type Ⅱ, but often there may be varying degrees of renal dysfunction, manifested as decreased endogenous creatinine clearance values; even serum creatinine, blood urea nitrogen levels.
6 Determination of serum complement C3 proliferative lesions of the membrane to identify meaningful.
7. Pathologic diagnosis of pathological types of minimal change disease, mesangial proliferative, membranous, focal segmental sclerosis, membrane proliferation and so on.

[Dialectical type]
1. Feng Shui flooding symptoms: eyelid and facial swelling, spread quickly after the body, limbs trapped sour heavy urination; can be both evil wind, nasal congestion, cough. Thin white fur, floating and tight pulse, and throat swelling and pain can be.
Symptoms analysis: wind cold outside attack, the nature of Qing Yang, and moisture Competing, the eyelid and facial swelling, spread quickly after the body; Feng Xie attack the lungs, lung failure Xuan Su, not water passage, the next lose bladder, the bodysorrow and grief trapped heavy urination; partial cold, could have bad cold, stuffy nose, cough, thin white fur, floating and tight pulse; partial wind heat, swelling and pain were seen in the throat, red tongue, yellow, floating pulse .
2. Dampness heat of symptoms: systemic edema, skin color, light stretch anxious, thirsty Fanre, abdominal fullness, red urine, constipation, or skin wound. Red, yellow and greasy coating, slippery pulse.
Syndrome analysis: moisture of evil, Yu and heat, stasis in the skin, so systemic edema, skin color, light stretch emergency; heat diffuse triple burner, air-lifting insane, abdominal fullness; heat Yongzhi, body fluid is not deck, the thirst Fanre; hot evil too much weight, then constipation, red urine; heat of the poison outward, and see the skin wound; red tongue, yellow greasy number of signs of damp.
3 kidney, deficiency symptoms: mild edema, or early morning floating face in the evening tarsal swelling, weak knees, fatigue drowsiness. Pink tongue, thin white or greasy moss, pulse.
Syndrome analysis: kidney are the main water, kidney water vapor, so, stop together on the inside, so the swelling less, or early morning floating face in the evening tarsus swollen; back the House of kidney, kidney, then the waist and knees; kidney of the refined gas shortage, so fatigue drowsiness;
Pink tongue, thin white or greasy, thin pulse of kidney deficiency, signs of moisture stagnation.
4 water stasis each knot symptoms: swollen limbs floating face recurrent, beginning to see the skin a mistake, swarthy, their names red thread, petechia petechiae, or both low back pain, red urine. Pale or dark red, the tongue edge with petechia, Department of stasis purple tongue bars, thin yellow or greasy astringent.
Syndrome analysis: moisture and bleeding each node, the proliferation of skin, so the surface floating limb swelling; blood stasis, poor blood, can not be outside the wing, you see the skin a mistake, swarthy, their names red thread, petechia ecchymosis; Liu Zhi in stasis, the blood does not follow through the line, not General low back pain, red urine; pale or dark red, the tongue edge with petechia, Department of stasis purple tongue bars, thin yellow or greasy thin astringent for the water signs of stasis in each node.
5 spleen deficiency symptoms: the whole body all swollen, not by the means, worse may be associated with pleural effusion, chest tightness, shortness of breath, loose stools thin, deficient urination, cold limbs, pale? S white. Tongue to talk about body fat, thin or greasy, thin pulse.
Syndrome analysis: moisture is not based, Kai He lost the Division, not the normal operation of the water solution discharge and stop in the body, overflow in the skin, so see the whole body all swollen, not according to the mean, worse may have pleural effusion occurs; wet and dirty on the pan, negative air machine, so the shortness of breath chest tightness; Spleen transportation of power, so the stool thin lining; Yang is not of gas, and urine deficient; yang deficiency, lost in the warmth, it is looking? s white, cold limbs ; tongue to talk about body fat, thin or greasy, thin pulse of spleen deficiency, signs of moisture inside the barricade.
6 liver and kidney yin deficiency symptoms: swollen repeated less, dizziness, Fanre thirst, sore throat, feeling irritable, sweating, backache, red urine. Red tongue, thin pulse a few strings.
Syndrome analysis: liver and kidney, do not wet the lag, it is not very swollen again; deficiency heat, so thirsty, sore throat; yin, then the dizziness; Hot on the disturbance of mind test irritable mood; kidney is backache;
Yin heat, the sweating, Fan; damp, so the red urine; red tongue, thready pulse string a few signs of liver and kidney.
7. Yin and yang failure symptoms: superficial eyelid, weakness, fatigue, pale complexion, voice, low mood, abdominal fullness, Oue poor appetite, mouth smell of urine, or urine deficient, or nocturia, worse then the faint confused, itching , convulsions, melena. Pale tongue, greasy moss rot, smooth pulse weak.
Syndrome analysis: wet muddy nostalgia of drugs, blood big injury, yin and yang of failure, so see the superficial eyelid, weakness, fatigue, pale complexion, voice low mood;
Toxic cloud does not drop, gas-poor, so abdominal fullness; wet and dirty on the pan, then Oue poor appetite, mouth urine smell; yin and yang of failure, it is deficient urination, or nocturia; virtual bad soul, so faint confused; poor blood, tendons and skin dystrophy, so see itching, convulsions; lost possession of the Division system, the blood does not follow through, so there melena; tongue pale and tired of corruption, weak pulse as the yin and yang failure smooth, turbid poison filled the elephant.

[And Treatment]
1. Feng Shui spread rule is: Shufeng Xuanfei, Qi Li water.
Recipe: Decoction plus surgery more spleen.
Ephedra 6 grams 30 grams of gypsum 12 grams Atractylodes 6 grams of licorice ginger, leather 9 g duckweed 9 Keze diarrhea skin 12 g Poria 12 g Plantago 12 grams (including fry) subtraction with the disease: partial cold, plus Nepeta, wind, sage, cassia twig of 9 grams, Morus alba, Tai Fupi 12 grams each, in order to facilitate Expel wind and cold water;
Partial wind-heat, add Rhizoma Imperatae, reed rhizome, red bean, Houttuynia, 30 grams, Scutellaria, Forsythia, 9 grams, 6 grams Campanulaceae to Shufeng heat water.
2 wet heat of the rule is evil: benefit-heat, diuresis swelling back.
Recipe: Yin Zi Shu chisel addition and subtraction.
Notopterygium 9 g 9 g of rhubarb Phytolacca 12 Keze diarrhea 15 g red bean head 3 g 30 Kechuan pepper nut 9 g Da Fupi 12 g Poria 12 grams 6 grams of licorice skin disease with the addition and subtraction: constipation barrier urgent illness who rhubarb dose increased to 15 grams, in order to strengthen the power of diarrhea constipation, plus tetrandrine 12 grams, Tinglizi after 15 minutes before the Cleveland water consumption; skin wound, plus flavescens, honeysuckle, forsythia 9 grams, 30 grams of dandelion, violet 12 grams, to detoxify.
3 kidney, deficiency rule is: Yi Yuan kidney, water swelling.
Recipe: Chi Sheng Qi Wan love together Polyporus Decoction.
Rehmannia 9 grams yam 15 grams Cornus 9 Keze diarrhea Polyporus Poria 12 grams 15 grams 12 grams 12 grams Codonopsis Coix seed 15 grams 12 grams Atractylodes Epimedium 12 grams 6 grams of licorice subtraction with the disease: fatigue worse, plus health Astragalus, Agrimony, 30 grams, jujube 15 grams, in order to benefit their strength; backache worse, Gadou Zhong, Achyranthes, Loranthaceae of 9 grams to kidney strong waist.
4 water stasis each knot rule is: brush the blood circulation of water stagnation line.
Recipe: Taohongsiwutang combined Polyporus Decoction.
Angelica 9 grams habitat 9 g Radix Rehmannia 9 g 9 g peach kernel 9 grams Chuanxiong 9 grams 6 grams of safflower Motherwort 15 Keze diarrhea 15 g Polyporus 12 g Poria 12 grams 6 grams of licorice subtraction with the disease: stasis worse, plusLeech 9 grams, the stasis; Qi, plus 30 grams of astragalus, Codonopsis 12 grams, the qi; liver and kidney, plus Ligustrum lucidum, Anemarrhena 9 grams each, to benefit the liver and kidney yin; spleen deficiency, plus Epimedium 12 grams, 9 grams aconite to warming yang.
5 spleen deficiency rule is: spleen and kidney, Wenyang water.
Recipe: Zhen Wu Tang decoction real spleen.
Fuzi 9 grams 12 grams Atractylodes ginger 9 g Da Fupi 12 Keze diarrhea 15 g Poria 12 grams Chen hyacinth shoots 9 g 9 g insects Magnolia TGP 9 g 9 g 6 g 6 grams of licorice wood subtraction with the disease: with pleural effusion, plus Tinglizi 9 grams, Plantago 15 grams (including fry), to facilitate water by drinking; loose stools thin, add yam, Coix seed, 15 grams, to spleen Qi; Yang Water Pan, breathlessness and can not be supine, urgent circumstances permit, plus Menispermaceae 9 grams, Chuanjiao Head 3 grams Tinglizi 12 grams, the level-by-breath.
6 Therapeutic liver and kidney yin deficiency: nourish liver and kidney, heat water.
Recipe: two to pills, Dabuyin Pill Polyporus Decoction.
Ligustrum lucidum 9 g 9 g of Eclipta turtle version Anemarrhena 9 g 15 g 15 g habitat Cork 9 Keze diarrhea Polyporus Poria 15 grams 15 grams 15 grams 15 grams Motherwort 30 grams Yiyiren 6 grams of licorice subtraction with the disease: edema than worse, plus 15 grams of Plantago grass, Chen hyacinth, bamboo worms 9 grams, to facilitate the withdrawal of water swollen; hematuria, increase thistle, thistle grass, raw madder, habitat stealing 12 grams each, to heat and cooling blood to stop bleeding.
7 Therapeutic failure of yin and yang: yin and yang pairs of fill, kidney Xiezhuo.
Recipe: Zuoguiwan together Wenpi Decoction.
Rehmannia 9 grams yam 15 grams medlar dogwood 9 g 9 g 9 Sanger Achyranthes parasitic dodder seed 12 g 12 g 9 g turtle antler version 9 g tuber 9 g 9 grams of rhubarb Serissa 30 Kdan Ref 15 grams of licorice 6 g with Modified disease: Oue vomiting, plus Evodia, berberine and 3 grams, 9 grams Jhuru to Jiangni vomiting; see melena, plus kitchen subsoil 30 grams, Burnet charcoal 12 grams, more blood in the stool; faint confused , plus Shichangpu 12 grams, with phlegm resuscitation; convulsions, add oysters, turtle, turtle version of 12 grams each, in order to Yin Xifeng; water vapor Ling heart, shortness of breath were not lying, plus Tinglizi 12 g , jujube 15 grams, by water to drink.

[Chinese medicine]
1 Pill per 4.5 grams, 2 times a day.
2 Ji Sheng Shen Qi Pills per 4.5 grams, 2 times a day.
3. Dabuyin pill every 4.5 grams, 2 times a day.

[Side] is simple
l. Astragalus 45 grams, Yiyiren 15 grams of earthworm 15 grams, 15 grams of Salvia, Motherwort 15 grams of honeysuckle 9 grams, Shuijianbi.

2 Corn 15 grams, watermelon rind 15 grams, 250 grams melon, beans 50 grams, plantain 25 grams, decoction, 2 times a day.

[] Other therapies
Acupuncture: Point Selection Shenshu, water, air sea, triple burner Yu, Sanyinjiao so, 1 day, 10 day cycle.
Diet:
(1) 30 grams of astragalus, cloud Poria 25 g, red bean 30 grams, Amomum 6 grams, 9 grams of ginger, the amount of water to cook for 30 minutes, would have been gutted and cleaned 250 g carp medicine Tong Jian, not salt to simmer for 40 minutes, the fish soup, daily or every other day.
(2) Astragalus 60 grams, hen, into the casserole, add water a total of Dunlan consumption.
(3) every morning to milk 250 ml, plus 1 egg.
(4), a fried soft-shelled turtle, without salt can add a little sugar consumption.
Enema: rhubarb 30 g, Burnet 15 grams, woody 9 grams.
Serissa 30 grams, boiled concoction of 200 ml of intestinal perfusion, the general temperature of 37 ℃ ~ 40 ℃, the liquid retained in the sigmoid colon enema section above, after filling liquid, appropriate to raise the hips, slowly pull out anal, Zhu Huanzhe supine rest for half an hour. Liquid retention in the intestine longer, the better.

PRECAUTIONS
1 Patients should pay attention to rest, to prevent infection, edema period should take no salt diet.
2 eating watermelon, melon, red bean, mung bean, Coix seed, corn and other benefits of water with the role of food. Not eat shrimp, crabs and other sea fishy fat objects, alcohol and tobacco and other stimulation products. Edema period can be changed to low-salt diet, other food taboos may be appropriate to a small amount of food, and eat according to the appropriate extent of the disease some protein, vitamin-rich food such as chicken, duck, fish, lean meat, etc., but not excessive.
3. To understand the pathological type of nephrotic syndrome, treatment and prognosis of positive significance. Such as minimal change disease more common in children, the prognosis is good.Membrane more common in adults, the prognosis is slightly worse.