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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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