"For the application of Yin" on the treatment of IgA nephropathy in Yang

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Although the treatment of kidney disease of traditional Chinese medicine does not depend on pathological type, but with the popularity of re


Although the treatment of kidney disease of traditional Chinese medicine does not depend on pathological type, but with the popularity of renopuncture technology, clinical encounter a number of IgA nephropathy patients due to various reasons, Chinese medicine treatment. In the course of treatment, Chinese medicine workers gradually discovered and summed up some rules, applied to the clinic has achieved certain curative effect. Is generally believed that yin deficiency is the main pathogenesis of [1] IgA nephropathy, the syndrome outcome showed two deficiency of spleen and kidney qi deficiency, yin deficiency, Qi and yin deficiency, yin and Yang in the process of [2]. But the traditional Chinese medicine's charm is that there are different treatments for the same disease differentiation in specific circumstances, which derived from the cold and warm, supplementation and attack, rise in drop, drop in winter, in the open close and close in the open, into retreat, retreat in advance in temperature, Wen Zhongyou, Qing Qing, Yang and Yin, Yin Yang treatment, its essence is still in pursuit of poor clinical efficacy of the treatment based on syndrome differentiation thought. We use several examples of "seeking Yang in Yin" thought case in IgA nephropathy in the treatment process, to talk about something, and fellow exchange.

First, IgA nephropathy (minor lesions) long-term proteinuria

* * *, male, 45. IgA nephropathy minor lesions (July 2010), long-term simple proteinuria, the highest 24 hours of protein quantification of 1.5 g, no edema, no hypertension, refused to use hormones, the current use of losartan potassium 100mg/ days. Recently increased fatigue, then in April 7, 2011 to see a doctor. V. fatigue, soreness and weakness of waist and knees, dry mouth, morning pain, tinnitus, dream, bubble urine, stool, red tongue, thin pulse string net. Check body: BP 115/70mmHg, double lower limbs is not swollen. Urine routine showed: urine protein (+ +), (-) red blood cells. TCM: liver kidney yin deficiency, treated by two to glutinous rehmannia pills. The parties are as follows:

Rehmannia 15, 15 Chinese yam, Cornus 12, Ligustrum Eclipta 30, 30,

White peony 30, Schisandra 9, corn 30, Sichuan Dendrobium 15, Zhu Fuling 9,

Lotus leaves 6, 9, 30 of rice kernel 30, Gorgon, born 157 agent germinatus

Two diagnosis, appeal to dream more slightly improved, Yaoxisuanruan, dry mouth, mouth pain, morning urine is still a bubble, red tongue net, small pulse string. Urine routine: urine protein (+). 24 hour protein quantitation 1.12 G. The top 15 plus 12 Sichuan Dendrobium, Radix Scutellariae, 12. 14 agent.

Three diagnosis, Yaoxisuanruan, dry mouth, residual symptoms improve, pink tongue net, small pulse string. Routine urine urine protein (+ +). With the above 9 cocoon shell, Astragalus 15. 14 agent.

Four, Yaoxisuanruan, dry mouth, pink tongue net, small pulse string. Routine urine urine protein (+ +). 24 hour protein quantitation 1.1 G. Appeal to have premature ejaculation impotent, hope to be adjusted at the same time. Then go to the above white peony, raw barley, bupleurum, and root 15, 15 eucommia, Morinda 12, 15 dodder, wood Steamed Buns 12. 14 agent.

Five diagnosis, Yaoxisuanruan, dry mouth has improved, pink tongue net, small pulse string. Urine routine: urine protein (small). The top 15 plus small stone reed. 14 agent.

Six diagnosis, disease, pink tongue net, small pulse string. Urine routine: urine protein (-). 24 hour protein quantitation 0.33 G. Prescription 14 agent.

Seven diagnosis, disease, pink tongue net, small pulse string. Urine routine: urine protein (-). After conditioning above February, after the return of the pill.

Analysis: IgA nephropathy prolonged course and superficiality, distinguish between yin and Yang, dialectical prescription medication, treatment period. In this case patients with syndrome of yin deficiency of liver and kidney, tonifying the liver and kidney, prescription drugs, although the diagnosis is accurate, the liver and kidney Yin after treatment difficult, poor efficacy. Four patients have symptoms because of impotence and premature ejaculation, then the previous Dihuangyinzi removal of Wenyang medicine re feeding, nourishing yin and Yang, all kinds of deficiency symptoms improved rapidly, proteinuria was effectively controlled. Although the clinical manifestations of patients with no obvious cold, a small, pale tongue, Yang deficiency syndrome, but patients with long-term proteinuria, microscopic leakage, liver blood deficiency, Jing Yue "in the essence of yin and Yang, yin and yang can not be away from the" Yin "good will for Yang Yin, Yin Yang, the the inexhaustible source."

Two, IgA nephropathy (mesangial proliferation) long-term hematuria

Wang x x, female, 37. IgA nephropathy and mesangial proliferative (April 2011), isolated hematuria, long-term follow-up urine show red blood cells (+) - (+ + +), hypertension and edema of lower extremities. Recently, feel dry mouth, backache, hair loss intensifies, then to the clinic in November 17, 2011. Urine protein in red blood cells (-), (+ +). V. dry mouth and throat, backache, hand foot heart heat, stool, night sleep is disturbed, normal menstruation, red tongue, moss net, thready pulse. TCM is kidney yin deficiency, Yin Huo wang. Governance to nourish the kidney Ning method, as follows:

"(each) born 12, 12, 10 and 15 shells, white peony, Ligustrum Eclipta 30, 30, 12, 15 Sichuan figwort, Dendrobium, fried Puhuang (package) 12, energy-saving 30, shepherd spent 15, 15 students germinatus. 7 agent.

Two diagnosis, such as before the disease, red tongue moss net, pulse thin string. Urine routine: urine protein (-), red blood cell (+). The top 15, 12 Radix Fructus aurantii. 14 agent.

Three diagnosis, dry mouth and throat complaints improved, backache still occasionally, night sweats, stool two days and more than in pond, as before, red tongue net, indented, pulse fine as before. Urine: urine protein (small), red blood cell (+ +). Add to the above Xianlingpi ophiopogon root, figwort, plus 12, evolvulus 15, total 15. 14 agent.

Four, dry mouth and throat, waist and knee action significantly improved, red tongue net, small pulse string. Urine routine: menstruation to not check. Above 6, the lujiaopian plus Gorgon 30. 14 agent.

Five diagnosis, the disease is flat, red tongue moss thin white, pulse slip. Urine routine: urine protein (-), red blood cell (0-3) /HP. The top of Fructus aurantii, fried puhuang. 14 agent.

Six diagnosis, the disease is flat, red tongue moss thin white, pulse slip. Urine routine: urine protein (-), red blood cell (0-3) /HP. The top 12 with bergamot, conditioning after February, Fugui Dihuang Pill follow-up rehabilitation. Follow up stability.

Analysis: hematuria is one of the main manifestations of IgA nephropathy in the acute phase of infection will increase when treated from the lung, or Shufeng heat, or Qingfei liyan. However, due to the different clinical symptoms (hematuria, proteinuria, edema, hypertension, etc.), pathological types, different stages, the treatment method is quite complicated. Especially the hematuria, due to traditional dialectical thought with lung heat IgA nephropathy in Yin deficiency, with nourishing Yin, clearing heat, nourishing blood Anluo, unless it's deficiency are less Yang method, avoid hemopyretic bleeding. This patient due to a disease of backache did not improve, then use the number of kidney medicine taste, to obtain better curative effect, dry mouth and throat, hand and foot fever, sweating and other deficiency syndrome were improved. Therefore, when prescribing drugs, only in the theory of yin and Yang between the interdependence and mutual transformation of the relationship, in order to avoid the treatment of absolute and one-sided, thereby improving the efficacy.

Three, crescentic IgA nephropathy with renal insufficiency, immunosuppressive therapy

Lou x, male, 38. IgA nephropathy with renal crescent in November 2009. A total of 9 grams of cyclophosphamide, prednisone 60mg. At present, the use of prednisone 10mg, losartan (Scr144umol/L 100mg, 44-132umol/L, BUN8.41 (reference value) reference value 2.14-7.14mmol/L), 24 hour protein 1.23. Then in December 1, 2010. V. backache, fatigue, dizziness, cold, dark red tongue, thin white fur, thready pulse. Check body: BP 110/70mmHg, mild edema of the lower extremities (+). Syndrome of deficiency of spleen and kidney, Yang deficiency and blood stasis, invigorating qi and warming the kidney and promoting blood circulation to cure. The parties are as follows:

30 Astragalus, Codonopsis 30, Salvia miltiorrhiza 30, 12 Atractylodes, Poria 15,

30 Mirengen, evolvulus 15, lujiaopian 6, Xianlingpi 12,

Guijianyu 30, three 12, 12 zedoary, Passepartout 12, rhubarb 15,

Malvae 15, cocoon shell 9, perilla 12, Centella asiatica 30. 14 agent.

Two diagnosis, symptoms without obvious improvement, 24 hours 1.33 grams of protein, urine protein (+ +), (+ +) red cells of dark red tongue, thin yellow greasy moss, pulse string. In the above add fried Puhuang diffusa 12, 15, 50 and 14 of yam, agent.

Three diagnosis, backache, cold symptoms improved, more still, red tongue, moss peeling, root greasy, thready pulse. Urine protein (+ +), (+) red cells. Further differentiation, when patients complained of dry mouth, at the same time according to the tongue in peel, add nourishing kidney Yin products, born 12, paeonol, Sichuan Dendrobium 30 shells 12. 14 agent.

Four, backache, fatigue, dizziness significantly improved, dark red tongue, thin yellow tongue coating, slippery pulse string. Urine protein (+), red blood cell (5-7) /HP. Corn 30 grams above. 14 agent. Prednisone reduced 5mg.

Five diagnosis, all the better, red tongue, moss thin yellow, pulse string slippery. 24 hour protein quantitation of 0.39 g, SCR99, BUN7.34, UA353umol/L. Continue to recuperate for six months, the situation is stable.

Analysis: the patients after treatment, immunosuppressive agents and hormone course of migration, the virtual card start possible two deficiency of yin and Yang, just at the beginning of treatment of patients with spleen kidney yang deficiency syndrome, the yin deficiency masked witness. After a period of treatment, the original is not the Yin Zhu Zheng began to appear, such as dry mouth etc.. At this point, if the warm yang qi, yin deficiency will be more serious, so that the disease is more complex and affect the treatment of the main disease. In theory, Yin Yang Zhiji, Yang Yin, yin and Yang, mutual root essence of each other, and can undermine gas (Shenyang); Yang deficiency and yin deficiency may, when accompanied by a certain degree of yin deficiency; when accompanied by a certain degree of yin deficiency, which is particularly common in patients with chronic illness. But the loss of Qi and Yin two, party a party may conceal, obviously, can also be mixed. Therefore, in the treatment of yin and Yang from the root theory, yin and Yang complement, a little emphasis, in order to achieve better results.

The theory of yin and Yang is the important component of yin yang theory in Chinese medicine. The theory of yin and Yang, yin and Yang of unity of opposites and transformation and other complex relationships, its conception is far more than a philosophical category. Zhao Xianke and Zhang Jingyue in the Ming Dynasty physicians don't cross "and" medicine "Jing Yue book" discusses the mutual relationship of the unity of the root of yin and Yang, and this relation is identified as congenital (Mingmen) only fire, developed for Yang, Yin Yang and Yin treatment and six pill, eight the pill as the representative of party theory, method, prescription and medicine system. The name only a few applications in the treatment of IgA nephropathy, while in other chronic renal diseases such as diabetic nephropathy, nephrotic syndrome and renal failure, and some refractory nephropathy treatment have more through the use of the interdependence between yin and yang theory by examination of the medical records, this summary and exploration will further enrich the the theory, clinical curative effect and help to improve the treatment of nephropathy with tcm.



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