How is uric acid blood nephropathy treated in Chinese medicine?

  Uric acid nephropathy is a kidney damage caused by excessive production or reduced excretion of uric acid in the blood to form hyperuricemia, often called gout nephropathy, clinical manifestations may have uric acid stones, small molecule proteinuria, edema, nocturia, elevated blood uric acid and renal tubular function damage, often combined with mild to moderate hypertension, hyperlipidemia, metabolic syndrome, prone to renal arteriosclerosis and cardiovascular disease.  Uric acid is the end product of purine metabolism, and there are two main sources of uric acid in human body: endogenous, which is produced by the metabolism of nucleoproteins in the body, accounting for about 80% of the total; and exogenous, which is produced by the metabolism of purine-rich food intake. The excretion of uric acid also has two main pathways: two-thirds through the kidneys and one-third through the intestines. When the production or excretion of uric acid is abnormal, it leads to an increase in blood uric acid concentration, where men >420umol/L and women >360umol/L, which is called hyperuricemia.  Previously, uric acid nephropathy was rare in China, but in recent years, due to the improvement of living standards, changes in dietary structure, and increased intake of protein and purine-rich foods, the incidence has increased. The disease is mostly seen in middle-aged and old-aged patients, 85% of them develop after 30 years old, and it is more common in men. If the disease is diagnosed early and given proper treatment (control of hyperuricemia and protection of renal function), the development of renal lesions can be reduced or stopped, but if treatment is delayed or inappropriate, the disease can deteriorate and develop into end-stage renal failure requiring dialysis treatment.  Treatment for uric acid nephropathy includes alkalinization of urine (sodium bicarbonate tablets), xanthine oxidase inhibitors (allopurinol), and promotion of uric acid excretion (benzbromarone). In addition, anti-hypertensive drugs such as cloxacin also have a certain degree of effect on lowering blood uric acid; activated carbon adsorbent can promote intestinal excretion of uric acid and can be used as an adjunctive treatment.  According to Chinese medicine, uric acid nephropathy belongs to “lumbago”, “stone shower”, “edema”, “paralysis”, “calendar”, and “nephritis”. It is also considered to be a category of “gout”, “gout” and “kidney labor”. Due to the deficiency of innate endowment, or overworking the kidney, resulting in deficiency of kidney essence; or dietary disorders, spleen qi weakness, dysfunction of the internal organs, unable to produce qi, blood and essence, but instead produce dampness, heat, phlegm and turbidity, internal flow of the internal organs, external paralysis and obstruction of joints and meridians. Weakness of the spleen and kidney is the key to the development of the disease, while dampness, heat and phlegm are important aspects of the development of the disease that cannot be ignored. The disease is prolonged, the spleen and kidney deficiency and dampness, heat and phlegm are mutually harmful, forming a vicious circle. As Gong Tingxian of the Ming Dynasty said: “All gout, limb pain, pain is fire, swelling is wet, do not eat meat. Meat is Yang fire, can help fire, eat then under the remains of drowning, within the lump, although oil fried hot things fish noodles, cut to quit.” In terms of treatment, the early, acute stage is treated by clearing heat and dampness, often with the addition and subtraction of Bazheng San and Si Miao San; the late, chronic stage is treated by tonifying the spleen and kidneys, benefiting Qi, invigorating blood and promoting dampness, often with the addition and subtraction of Ginseng Qi Dihuang Tang and Tao Hong Siwu Tang.  In addition, modern pharmacological research has confirmed that Coix Seed, Tu Fu Ling, Che Qian Zi, Huang Bai, Atractylodes, Sericeae and Ze Lan have the effect of promoting uric acid excretion; Wei Ling Xian and Gentiana Macrophylla not only have the effect of increasing uric acid excretion and anti-gout, but also can promote uric acid dissolution; Rhubarb, Angelica and Ze Lan can inhibit uric acid synthesis, improve renal blood flow, reduce the damage of inflammatory cells and inflammatory mediators on renal tubular-interstitial, reduce capillary permeability, and reduce the risk of kidney disease. Capillary permeability, reduce exudation and local joint swelling and pain; Cicada, as a worm-derived fungus similar to Cordyceps, can relieve heat and analgesia, reduce inflammatory cells and inflammatory mediators on renal tubular-interstitial damage, reduce serum creatinine and urea nitrogen, protect renal function, delay the process of glomerulosclerosis and interstitial fibrosis, and also regulate immunity, lower blood sugar, improve lipid metabolism, and anti-atherosclerosis.  Prevention and health care for uric acid nephropathy include: 1, avoid eating foods containing high purine: such as animal offal and brain, sardines, etc., do not eat meat soup, eat less protein and fat, abstain from alcohol to reduce the production of exogenous uric acid.  2, drink more water: maintain urine volume of about 2000ml per day, keep enough urine volume to prevent the formation of stones; keep the bowels open to facilitate the excretion of uric acid.  3. Prevent alcoholism, lactic acidemia, diabetic acidosis, pregnancy poisoning, etc.: to reduce the occurrence of hyperuricemia.  4, Chinese herbal food therapy: 30g of raw hawthorn, 30g of papaya, 15g of raw lotus leaf, 30g of plantain boiled juice to remove slag, to juice cooked raw coix seeds 50g for porridge, with the food; corn beard decoction for water, raw hawthorn tea, often drink, suitable for the prevention and treatment of hyperuricemia.