TCM Syndrome Differentiation and Treatment for Chronic Nephritis
Chronic nephritis primarily presents with persistent edema, high blood pressure, anemia, proteinuria, and cylindruria. TCM syndrome differentiation and treatment mainly fall into the following types:
① Water-Dampness Invading Type: Prominent edema, pale complexion, fatigue, cold intolerance, lower back pain with chest tightness and abdominal distension, difficulty urinating, deep and taut pulse, thin, swollen tongue with greasy coating. High levels of proteinuria, low plasma protein, elevated cholesterol—consistent with nephrotic type chronic nephritis. Treatment aims to promote lung function, strengthen the spleen, and eliminate dampness. Use the following herbs: Ephedra 9g, Mulberry Bark 30g, White Atractylodes 15g, Siler 15g, Stephania 15g, Citrus Peel 12g, Poria Skin 30g, Large Belly Skin 15g. Boil in water and take orally.
② Spleen-Kidney Deficiency Type: Mild edema, normal urine output, fatigue, dizziness, tinnitus, lower back pain, reduced appetite, diarrhea, pale tongue with thin coating, deep and fine pulse. High proteinuria, low plasma protein. Treatment aims to warm the kidneys, promote diuresis, tonify qi, and strengthen the spleen. Use the following formula: Perilla 30g, Astragalus 30g, Atractylodes Macrocephala and Atractylodes Lancea each 9g, Stephania 15g, Poria Skin 30g, Citrus Peel 12g, Red Adzuki Beans 30g, Prepared Aconite Root 9g, Purple Garlic 5 cloves. Boil in water and take orally.
③ Upper Excess, Lower Deficiency Type: Headache, dizziness, tinnitus, no obvious edema, lower back pain, thin yellow or white coating, fine wiry or rapid pulse, persistently high blood pressure (24.0–21.3/14.7–12.0 kPa). Moderate proteinuria, few red blood cells in urine—consistent with hypertensive type chronic nephritis. Treatment aims to nourish yin and subdue yang. Use the following formula: Polygonatum 30g, Scrophularia 15g, Morus Fruit 30g, Ligusticum 9g, Scutellaria 15g, Tortoise Shell (processed) 15g, Anemarrhena 12g, Phellodendron 12g, Agastache 12g, Eucommia 15g, Taxillus 30g, Calcareous Oyster Shell and Dragon Bone each 30g. Boil in water and take orally.