Nephrotic syndrome can be caused by a wide variety of glomerular
diseases. It may follow bacterial or viral infection, malignant
tumors and administration of some drugs. Some immune diseases,
such as systemic lupus erythematosus, allergic purpura and
diabetes mellitus can be complicated by nephrotic syndrome. This
disease is included in the categories of "shui zhong" (edema),
and "xu lao" (consumptive diseases) in TCM.
Main
Points of Diagnosis
1. Heavy proteinuria, accompanied with edema and
hypoproteinemia, are three major manifestations of this
syndrome. Urinary protein excretion exceeds 3.5g per day. The
serum albumin is lower than 30g per liter. Severe edema may
appear if serum albumin is lower than 15g per liter.
2. The alteration of blood pressure varies with different types
of the disease. Hyperlipemia is common, particularly increased
cholesterol.
3. About 75 per cent of cases with nephrotic syndrome are caused
by primary glomerular diseases. In children nearly 80 per cent
of cases are nephrotic syndrome of minute lesion type. The rest
are secondary to other diseases. Renopuncture biopsy is of much
help in confirming the cases of the diseases and indicating
treatment.
Differentiation and Treatment of Common Syndromes
1. Insufficiency of the Spleen-Yang and
Kidney-Yang
Main Symptoms and Signs: Sallow complexion, mental fatigue, cold
extremities, bodily edema which is more severe in the region
below the waist, anorexia, loose stool, weakness of the loins,
oliguria, pale or plump moist tongue with whitish smooth fur,
deep, thready and weak pulse.
Therapeutic Principle: Warming the kidney, strengthening the
spleen and inducing diuresis to alleviate edema.
Recipe: Modified Drink for Reinforcing the Spleen in combination
with Diuretic Decoction for Strengthening Yang of the Spleen and
Kidneys.
astragalus root
codonopsis root
white atractylodes rhizome
poria
coix seed
prepared aconite root
cinnamon bark
umbellate pore-fungus
aucklandia root
epimedium
All the above herbs are to be decocted in water for oral
administration.
2. Weakness of the Kidney-Qi
Main Symptoms and Signs: Pale complexion, general debility with
desire for sleep, aversion to cold, pitting edema, hydrops in
the scrotum or hydrothorax and ascites frequent urination at
night (with profuse proteinuria), pale, swollen and
teeth-printed tongue with whitish fur, deep and slow pulse.
Therapeutic Principle: Strengthening the function of the kidney
to stop proteinuria.
Recipe: Kidney-Yang-Reinforcing Bolus with additional
ingredients.
prepared rehmannia root
Chinese yam
dogwood fruit
wolfberry fruit
dodder seed
prepared aconite root
cinnamon bark
astragalus root
codonopsis root
lotus seed
Cherokee rose-hip
euryale seed
poria
unbellate pore-fungus
All the above herbs are to be decocted in water for oral
administration.
If the case is complicated with symptoms of
dampness and heat, 10 grams of phellodendron bark 15 grams of
tale and 20 grams of coix seed ought to be added to the recipe.
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