Diabetic nephropathy is a refractory disease. According to the course of disease and pathological changes of diabetic nephropathy, Mogensen
Diabetic nephropathy is a refractory disease. According to the course of disease and pathological changes of diabetic nephropathy, Mogensen had suggested that diabetic nephropathy is divided into the following five stages: 1 glomerular filtration and renal hypertrophy during this initial change is consistent with the high blood glucose level, blood glucose control can be obtained after partial remission. No histopathological lesions were present. 2 normal albuminuria: GFR higher than normal. Renal pathology showed GBM thickening, mesangial matrix increased after exercise, urinary albumin excretion rate (UAE) increased (> 20 g/min), 3 early diabetic nephropathy, also known as the "persistent microalbuminuria period" GFR began to fall to normal. Renal pathological changes in glomerular nodular lesions and small artery hyaline degeneration. UAE continued to rise from 20 to 200 g/min, resulting in microalbuminuria. 4 clinical diabetic nephropathy: a typical pathological K-W nodules. Persistent massive albuminuria (UAE> 200 g/min) or proteinuria is greater than 500mg/d, about 30% of patients with nephrotic syndrome, GFR continues to decline. This period is characterized by urinary protein does not decrease with the decrease of GFR. Once the patient into the IV period, the disease is often sexual development, if not actively controlled, GFR will average monthly decline of 1ml/min. 5 end stage renal failure: GFR< 10ml/min. The amount of urine protein decreased due to glomerular sclerosis. Symptoms of uremia, dialysis treatment.
Once found the diabetic proteinuria, the condition is advanced, the kidney microvascular damage associated with dyslipidemia, protein leakage, high perfusion renal hyperfiltration, accelerating glomerular damage, accelerate the residual nephron damage, with obesity and dyslipidemia, lipid metabolism and toxicity increased kidney damage. Early symptoms of diabetes are recorded, the main pulmonary elimination, thirsty polyorexia stomach fire, polyuria and renal elimination. For the heat of lung and stomach syndrome of kidney yin deficiency and lack of Tripitaka, by Yang, lung and kidney, deficiency, cold and heat. The use of Gastrodia side cold and kidney, angry, often play an unexpected effect, can reduce proteinuria, slow the progression of nephropathy.
Cite a case as follows:
The 45 year old male patient, 10 years of diabetes, proteinuria more than 3 years, 24 hour urinary protein quantitative 5.5G, two severe lower extremity pitting edema of renal function, serum creatinine 145mmol/L, albumin, 24g/L, with 3 diabetic retinopathy, kidney size normal, mild anemia. Clinical diagnosis of diabetic nephropathy IV phase CKD3. History of hypertension 5 years. Deny the history of allergies. History of tuberculosis. The usual Humulin 70/30 subcutaneous injection of blood glucose control, blood glucose control, glycated hemoglobin in about 8%. Fat tongue, yellow greasy moss, pulse weak.
Given GTEB squared cut treatment, 9, 9, Gastrodia elata 9, Scutellaria Coptis tablets 15, 9, 5, ginger cinnamon rhubarb 40, gentian 9, gardenia 15, 12, 30, Sanleng Ezhu peach 30. Decoction for the treatment of 3 months, sometimes given 3 grams of pangolin, powder and swallow, Poria, diuresis and detumescence etc. on the product. Edema gradually subsided, with the addition of mucosal side treatment. 24 hours reduced to 1-2g plasma albumin rose to normal and stable renal function. In the gastrodin, Scutellaria, phellodendron bark, rhubarb, gardenia, gentian liver purging, clear heat, dampness heat, aconite, cinnamon, ginger gun wenshenhuatan, improve renal blood vessel function, mucosal side dredging the triple energizer, Tongli channel, improve renal function, reduce urinary protein leakage.
The key is to treatment, patients from the "wet" state to "dry" state, that is to reduce the proteinuria from nephrotic syndrome to non nephrotic syndrome, renal function to avoid rapid progression in end-stage renal failure, need replacement therapy. Chinese medicine cold and warm air, kidney, significant effect.