Traditional Chinese medicine formula for treating chronic nephritis
Treatment of Chronic Nephritis with Motherwort and Astragalus membranaceus
Its main functions are tonifying deficiency, consolidating constitution, promoting blood circulation, removing blood stasis, and removing toxic substances and pathogens. Indications: Chronic nephritis.
The folk prescription consists of motherwort 30g, astragalus 20g, angelica 20g, codonopsis pilosula 15g, chuanxiong rhizome 12g and safflower 12g.
Usage and dosage: decocted in water, daily 1 dose, taken continuously. Urine test every week 1 time, if it is negative for three times in a row, the decoction can be changed into pills or powder, and the medication can be maintained for 2 ~ 6 months to consolidate the curative effect.
Poria cocos 18g, Cornus officinalis, Cuscuta chinensis 15g, Atractylodes macrocephala 12g, and Cinnamomum cassia 6 g are added for patients with spleen and kidney yang deficiency; For patients with deficiency of both lung and spleen, add 20 grams of Chinese yam and Cimicifuga rhizome 12 grams; For patients with liver and kidney yin deficiency, add 20 grams of Eclipta prostrata; Fructus Ligustri Lucidi, Carapax et Plastrum Testudinis, Fructus Corni, meat each15g; For patients with deficiency of both qi and yin, Radix Scrophulariae, Radix Rehmanniae, Radix Ophiopogonis and Rhizoma Polygonati15g are added; For acute attack, 25 grams of cogongrass rhizome, 5 grams of Taraxacum, Flos Lonicerae and Radix Isatidis/kloc-0 were added respectively; Coicis Semen, Plantaginis Semen 65438 05g, Polyporus, Alismatis Rhizoma 65438 02g, Pericarpium Arecae 65438 00g, Prunellae Spica 30g, Oyster 20g, Radix Paeoniae Alba and Chrysanthemum 65438 05g are added to patients with short and swollen urine.
54 cases were treated with this prescription. After 30 days of treatment, the curative effect was evaluated: 33 cases were markedly effective, 65,438+05 cases were effective, and 6 cases were ineffective. The total effective rate was 88.9%.
Shenqi Zisi Decoction in Treating Chronic Nephritis
Indications: benefiting qi and promoting blood circulation. Indications: Chronic nephritis.
The recipe consists of Radix Codonopsis 15g, Radix Astragali 30-60g, Semen Cuscutae 15g, Radix Salviae Miltiorrhizae 15g, Radix Angelicae Sinensis 12g, Semen Persicae 10g, Flos Carthami 10g, Herba Leonuri 30-60g, and Fructus Snow.
Usage and dosage: daily 1 dose, decocted with water.
40 cases were clinically treated, and the total effective rate was 86.4%. The effective rate of hypertension type was 81.8%; The effective rate of nephrotic syndrome was 57.65438 0%. The effective rate of hematuria patients under microscope was 77.8%. The effective rate of patients with abnormal renal function was 77.8%.
Treatment of Chronic Nephritis with Astragalus and Houttuynia Cordata Thunb.
Functions: invigorating kidney and spleen, clearing away heat and toxic materials, promoting blood circulation and removing blood stasis. Indications: Chronic nephritis. Symptoms include facial edema, shortness of breath, shortness of breath, mental fatigue, backache, loss of appetite and oliguria. The tongue is pale and dark, and the coating is thin and white or slightly yellow and greasy.
The prescription consists of 45g of Radix Astragali, 30g of Herba Houttuyniae, 30g of Herba Hedyotidis Diffusae, 5g of Lumbricus 1, 20g of Herba Leonuri, Radix Salviae Miltiorrhizae, Periostracum Cicadae, Flos Lonicerae and 20g of pig kidney1.
Usage and dosage: daily 1 dose, decocted with water.
Through case verification, this prescription treated 4 1 case, and the results showed that1case was cured in 5 cases, markedly effective in 2 cases, improved in 3 cases, and ineffective in 2 cases, with a total effective rate of 95. 1%.
Treatment of chronic nephritis with LYSIMACHIA LYSIMACHIA and Jujube
Indications: Chronic pyelonephritis.
The folk prescription consists of 30 grams of Lysimachia christinae (whole grass) and 6 Chinese dates.
Usage and dosage: the first decoction is taken on an empty stomach 1 time, and the second decoction is tea, daily 1 dose. Take it for a long time or increase the dose.
Lysimachia odorata should avoid exposure to the sun, so as to avoid the effect of leaves and fruits falling off.
It was proved by cases that 6 cases of chronic pyelonephritis/kloc-0 were treated with this prescription, and all of them were cured. Among them, 4 cases only took 12 dose, 1 case took 80 doses, and generally took 15 ~ 20 doses to recover. Two cases were followed up 10 and 5 years respectively, and the rest were followed up for 2 ~ 4 years, and no recurrence was found.
Etiology of chronic nephritis
Chronic glomerulonephritis is a group of chronic glomerular diseases with multiple causes, but the etiology of most patients is unknown and has no clear relationship with streptococcus infection. According to statistics, only 1.5% ~ 20% is transformed from acute glomerulonephritis. In addition, most patients with chronic nephritis have no history of acute nephritis, so many scholars believe that there is no positive correlation between chronic glomerulonephritis and acute nephritis, which may be caused by various infections such as bacteria, viruses or protozoa through immune mechanisms, inflammatory mediators and non-immune mechanisms.
clinical picture
According to the different clinical manifestations, it can be divided into the following five subtypes:
1. Common type
More common. The course of the disease is prolonged and the condition is relatively stable. Most of them are mild to moderate edema, hypertension and renal function damage. Urinary protein (+) ~ (++), microscopic hematuria, tubular urine. Pathological changes are common in IgA nephropathy, non-IgA mesangial proliferative glomerulonephritis, focal mesangial proliferative glomerulosclerosis and membranous proliferative glomerulonephritis.
2. Nephrotic massive proteinuria
In addition to the common manifestations, some patients may show a lot of proteinuria caused by nephropathy, and the pathological types are mostly minimal change nephropathy, membranous nephropathy, membranous proliferative nephritis and focal glomerulosclerosis.
3. Types of hypertension
In addition to the above-mentioned common manifestations, the main manifestations are sustained and moderate increase in blood pressure, especially continuous increase in diastolic blood pressure, which is often accompanied by retinal artery stenosis, tortuous and arteriovenous cross-compression, and a few may have flocculent exudates and/or bleeding. Pathological manifestations are focal segmental glomerulosclerosis and diffuse hyperplasia, or late stage of non-stereotyped or existing glomerulosclerosis.
4. Mixed type
Clinically, there are both manifestations of nephropathy and hypertension, and they are often accompanied by signs of renal insufficiency in different degrees. Pathological changes can be local segmental glomerulosclerosis and advanced diffuse proliferative glomerulonephritis.
5. Acute attack type
In the process of relatively stable or continuous progress, due to bacterial or viral infection or overwork, after a short incubation period (1 ~ 5 days), clinical manifestations similar to acute nephritis appear, and after treatment and rest, they can recover to the original stable level or the condition deteriorates, and uremia gradually appears; Or after repeated attacks, renal function drops sharply, resulting in uremia and other clinical manifestations. Pathological changes were diffuse hyperplasia, crescents on the basis of glomerulosclerosis and/or obvious interstitial nephritis.
cheque
Laboratory and other inspections:
(1) Abnormal urine test is the basic sign of chronic nephritis. Proteinuria is the main basis for the diagnosis of chronic nephritis. Urine protein is generally 1 ~ 3g/ day, and urine sediment can be seen as granular tube and transparent tube. Most patients can have microscopic hematuria, and a few patients can have intermittent gross hematuria.
(2) Renal function test Most patients with chronic nephritis may have decreased glomerular filtration rate (GFR) in different degrees, which is manifested by decreased creatinine clearance rate in the early stage, and then increased serum creatinine. It may be accompanied by different degrees of renal tubular dysfunction, such as decreased urine concentration function of distal renal tubular and/or decreased reabsorption function of proximal renal tubular.
differential diagnosis
Chronic glomerulonephritis needs to be differentiated from the following diseases:
1. Secondary glomerulonephritis
Such as lupus nephritis and henoch-schonlein purpura nephritis, can be differentiated according to the corresponding system manifestations and specific laboratory tests.
2. Hereditary nephritis (Ahlport syndrome)
It often begins in teenagers, and the patients have eyes (spherical lens), ears (nervous deafness) and kidney abnormalities, and have a positive family history (mostly sex-linked dominant inheritance).
3. Other primary glomerular diseases
(1) occult glomerulonephritis is mainly characterized by asymptomatic hematuria and/or proteinuria, without edema, hypertension and renal insufficiency.
(2) Acute nephritis after infection has precursor infection, which begins with acute attack. Chronic nephritis should be differentiated from this disease. The incubation period is different, and the dynamic change of serum C3 is helpful to distinguish them. The prognosis of the disease is different, and chronic nephritis has no self-healing trend, showing chronic progress.
4. Primary hypertensive renal damage
First, long-term hypertension, and then kidney damage. Clinically, the damage of distal renal tubular function is earlier than that of glomerular function, and the urine changes slightly, with only a small amount of protein, which often leads to other target organ complications of hypertension.
Treatment of chronic nephritis
In the early stage of chronic glomerulonephritis, corresponding treatment should be given according to its pathological types, so as to inhibit immune-mediated inflammation, inhibit cell proliferation and alleviate renal sclerosis. The main purpose should be to prevent or delay the progressive deterioration of renal function, improve or alleviate clinical symptoms and prevent complications. The following comprehensive control measures can be taken:
1. Actively control hypertension
Prevent renal dysfunction or improve impaired renal function, prevent cardiovascular complications and improve long-term prognosis.
(1) Treatment principle ① Try to reach the target value, such as urine protein.
(2) Treatment methods ① Non-drug therapy should limit the intake of dietary sodium, and patients with hypertension should limit the intake of sodium, and the intake of sodium should be controlled at 80 ~ 100 mmol. Antihypertensive drugs should be carried out on the basis of limiting sodium diet: adjusting the intake of dietary protein and potassium-containing foods; Quit smoking and limit alcohol; Lose weight; Proper exercise, etc. ② Antihypertensive drugs commonly used in drug therapy include angiotensin converting enzyme inhibitor (ACEI), angiotensin Ⅱ receptor antagonist (ARB), long-acting calcium channel blocker (CCB), diuretic, etc. Receptor blockers, etc. ACEI and ARB should be the first choice, because they not only have the function of lowering blood pressure, but also have the renal protection function of reducing urine protein and delaying the deterioration of renal function. The application of ACEI or ARB in patients with renal insufficiency should prevent hyperkalemia and the increase of serum creatinine, and the serum creatinine is greater than 264? It is necessary to use Mol/L(3mg/dl) carefully under close observation, especially to monitor renal function and prevent hyperkalemia. A few patients with persistent dry cough caused by ACEI can switch to ARB.
2. Reduce urinary protein
Delaying the decline of renal function, proteinuria is closely related to the decline of renal function and should be strictly controlled. ACEI and ARB can reduce urine protein, and the dosage of ACEI and ARB is often higher than that needed for blood pressure reduction. But the occurrence of hypotension should be prevented.
3. Limit the intake of protein and phosphorus in food.
Low protein and low phosphorus diet can reduce glomerular hypertension, high perfusion and high filtration, and delay glomerular sclerosis. Patients with azotemia due to renal insufficiency should limit their intake of protein and phosphorus, adopt a high-quality low-protein diet or add essential amino acids or? Ketoacid
4. Avoid factors that aggravate renal damage.
Infection, hypovolemia, dehydration, fatigue, water, electrolyte and acid-base balance disorder, pregnancy and application of nephrotoxic drugs (such as aminoglycoside antibiotics, non-steroidal anti-inflammatory drugs, contrast media, etc. ) may damage the kidneys and should be avoided or used with caution.
5. Glucocorticoids and cytotoxic drugs
Because chronic nephritis is a clinical syndrome including many diseases, its etiology, pathological type and degree, clinical manifestations and renal function are quite different, so whether to use glucocorticoid and cytotoxic drugs should be determined according to the etiology and pathological type.
6. Others
Antiplatelet drugs, anticoagulants, statins and traditional Chinese medicine can also be used.
prognosis