Treatment of Chronic Nephritis by TCM Syndrome Differentiation and Treatment
Chronic nephritis primarily manifests as persistent edema, elevated blood pressure, anemia, proteinuria, and cylindruria. TCM syndrome differentiation and treatment mainly include the following types:
① Water-Dampness Infiltration Type: obvious edema, pale complexion, fatigue, cold intolerance, lumbago with chest tightness and abdominal distension, poor urination, deep wiry pulse, thin white coating on a swollen tongue, etc. There is massive proteinuria, low plasma protein levels, and elevated cholesterol, consistent with nephrotic type chronic nephritis. Treatment should focus on promoting lung function, strengthening the spleen, and diuresis. The following herbs are used: Ephedra 9g, Mulberry Bark 30g, Atractylodes 15g, Saposhnikovia 15g, Stephania 15g, Citrus Peel 12g, Poria Skin 30g, Large Belly Skin 15g, decocted and taken orally.
② Spleen-Kidney Deficiency Type: mild edema, normal urine volume, fatigue, dizziness, tinnitus, lumbago, reduced appetite, diarrhea, pale tongue with thin coating, deep fine pulse, massive proteinuria, and low plasma protein levels. Treatment should warm the kidneys, promote diuresis, tonify qi, and strengthen the spleen. The following formula may be used: Perilla 30g, Astragalus 30g, White Atractylodes and Chinese Atractylodes each 9g, Stephania 15g, Poria Skin 30g, Citrus Peel 12g, Red Adzuki Bean 30g, Prepared Aconite Root 9g, Purple Garlic 5 cloves, decocted and taken orally.
③ Upper Excess, Lower Deficiency Type: dizziness, headache, tinnitus, no significant edema, lumbago, thin yellow or thin white coating, fine wiry or rapid pulse, persistently high blood pressure (24.0–21.3/14.7–12.0 kPa). Minimal proteinuria, small amount of red blood cells in urine, consistent with hypertensive type chronic nephritis. Treatment should nourish yin and subdue yang. The following formula is used: Polygonatum 30g, Scrophularia 15g, Morus Fruit 30g, Ligusticum 9g, Coptis 15g, Processed Softshell Turtle Shell 15g, Anemarrhena 12g, Phellodendron 12g, Spiny Solomon’s Seal 12g, Eucommia 15g, Taxillus 30g, Calcined Oyster Shell and Hematite each 30g, decocted and taken orally.