Many of its contents on kidney diseases have had a significant impact on the treatment of kidney diseases in later generations. The contents of the treatment of kidney diseases are summarized into ten methods, which are described here.
I. Promoting the lung and relieving the surface of the body, sending out the water qi Wei Lianbo, Department of Nephrology, Zhujiang Hospital, Southern Medical University
The Jin Kui Essentials – water qi disease pulse evidence and treatment of the 14th cloud: “wind and water evil wind, all over the swelling, pulse floating not (and) thirst, continued from sweating, Yue maid Tang main”. “Water in the person, the whole face and eyes yellow swelling, the pulse is sunken, the urine is not conducive, so that the disease water. If the urine is spontaneous, this is the death of fluid, so that thirst is also, the main of Yue maidservant plus art soup. The six flavors of the right, six liters of water, first boil ephedra, remove the froth, within the medicine, boil three liters, divided into three servings of warm. The evil wind, plus a piece of sapodilla, cannon.
The lung is the main surface, and is the fence of the whole body. The lung loses control of the water channel, and the wind and water overflow out of the veins to develop edema, which is caused by wind and water. Feng Shui characteristics: (1) evil wind and other superficial evidence; (2) floating pulse; (3) swelling of the whole body mainly in the face; (4) thirst, sweating. Feng Shui refers to the water between the skin and the couples, and the upper body is the main, can not use Fu Ling Zelig water to expel the water, Jing Yun: all diseases edema swelling above the waist, when sweating is healed, and to use the method of sweating to send over the water to eliminate swelling, so the more handmaid soup with ephedra, ginger hair over the water, the patient has thirst and spontaneous sweating, indicating that the body has heat, single use of ephedra ginger fear of heat injury, so with raw gypsum can be accompanied by the warmth of ephedra ginger. Leave the function of sweating and sending out water qi, so that ephedra from pungent warmth to dispel wind and cold to pungent coolness to dispel wind and water qi. Therefore, the maidservant soup is the treatment of wind and water with heat evidence.
If ① the pulse is not floating but sinking; ② the superficial evidence of bad wind is also gone; ③ the face is atrophied; ④ the swelling of the whole body is mainly in the face and eyes, and the urine is unfavorable. The wind-water surface evidence has been resolved, but the edema is not resolved, so the spleen is internally transmitted, and the spleen is restricted in transporting water-dampness. If the urine is spontaneous and the mouth is thirsty, this is the death of fluids, so we cannot use Yue Maida Plus Art Tang which is used to develop water qi.
Acute nephritis, acute attack of chronic nephritis or nephrotic syndrome with malignant chills and fever, sore throat epiphenomenon, along with unfavorable urination and edema, are Feng Shui in Yang water of Chinese medicine has a better effect.
In an animal model of chronic glomerulonephritis in which Liu Shumin [1] intervened with Echinacea Plus Art Tang, the kidney pathology showed that the lesions were less severe than those in the model group, and the cell membranes, nuclei and organelles in the cell mass were relatively normal under electron microscopic ultrastructure. It is shown that Yohimu Plus Art Tang has a protective effect on kidney tissues and can slow down the progress of chronic nephritis.
Benefiting qi and draining wind, strengthening the spleen and inducing diuresis
The Golden Horoscope – water and gas disease pulse evidence and treatment: “wind and water, the pulse floats body heavy, sweating and evil wind, the main body of Fangji Huangqi Tang, abdominal pain, plus peony.” Fangji Huangqi soup: Fangji one two, astragalus one two one (remove reed), white atractylodes seven and a half money, licorice half two (fried).”
With the aforementioned Feng Shui both have sweating, bad wind, and floating pulse. However, the sweating in the previous article is continued from sweating, which is the sign of wind from heat, while the sweating in this article is the evidence of surface deficiency. The former article in the surface of the wind evil is more, so highlight the evil wind in the front, this article of the wind evil is not very, evil wind in the sweat after. The former article is all swollen, this article body weight is the main, body weight for water in the table, so this article discusses the wind and water table deficiency evidence. Therefore, this article deals with Feng Shui superficial deficiency evidence. Therefore, it is used to promote water, Huang Qi to benefit Qi and fix the surface, Bai Zhu to strengthen the spleen and resolve dampness, Sheng Jiang and Dazao to harmonize Ying and Wei, and Gan Cao to harmonize the middle.
Xu Jianping et al [2] applied Fangqi Huangqi Tang combined with Wu Ling San to treat idiopathic edema and achieved satisfactory results. Zhang Kun et al [3] treated chronic nephritis with Fangji Huangqi Tang and showed that the formula had a significant effect in reducing proteinuria.
Yu et al [4] showed that Fangqi Huangqi Tang significantly reduced blood urea nitrogen, renal tubular and interstitial fibroblast marker proteins a-smooth muscle protein and fibronectin and gene expression in unilateral ureteral ligation rats, thereby reducing interstitial fibrosis. Yu Dongrong et al [5] showed that Fangqi Huangqi Tang had a protective effect on foot cells in a rat model of chronic kidney disease and reduced urinary protein and blood creatinine in the model rats.
Pharmacological studies showed that Astragalus has the ability to enhance the immune function of the body, significantly promote the synthesis of serum and liver proteins, and enhance the anti-stress ability of rats by improving the adrenal cortical function. Fangqi has anti-inflammatory, immunosuppressive and anti-allergic, and anti-interstitial kidney fibrosis effects. Atractylodes macrocephala has various biological activities such as anti-fatigue and anti-coagulation, and reduces creatinine level by diuretic and regulating peritoneal pore opening. Animal experiments have proved that Fangji Huangqi Tang can prevent the occurrence of interstitial fibrosis by protecting foot cells and reducing blood urea nitrogen in rats, increasing albumin levels, and significantly reducing the expression levels of renal tubular and interstitial a-SMA and FN.
Warming kidney yang, resolving qi and moving water
The sixth chapter of the Jin Kui Yao Yao (The sixth chapter of the Jin Kui Yao – blood paralysis and deficiency labor disease pulse evidence and treatment): “deficiency labor back pain, less abdominal constriction, urinary inconvenience, the eight flavors of the kidney qi pill is the main” and “thirst and urinary inconvenience gonorrhea pulse evidence and treatment of the thirteenth”: “men thirst, urine, to drink a bucket, urine a bucket, the kidney qi pill is the main. ” Eight flavors of kidney qi pills: dried ground Huang eight two, potato four two, Cornus officinalis four two, Zelig three two, Poria three two, peony bark three two, cinnamon one two, sapodilla (gun) one two.
The previous article discusses the deficiency of kidney yang deficiency strain evidence treatment. Waist for the kidney outside the internal organs, kidney Yang deficiency is waist pain; kidney deficiency, the bladder is not conducive to gasification, so the abdomen is constricted, urine is not conducive. Therefore, the use of eight flavors of kidney qi pill to help the weakness of Yang to transform water, nourishing the yin of the kidney to get angry, then deficiency labor can be cured. The latter article deals with the evidence and treatment of lower elimination. The kidney is the organ of water and fire and contains true yin and true yang, so kidney yin deficiency and kidney yang deficiency or both yin and yang deficiency of the kidney can cause thirst. This article deals with the lower extinction evidence of Yang deficiency. Kidney deficiency and Yang weakness, not only can not transpire fluids to moisten, but also can not transform Qi to take in water, so drink a bucket, urinate also a bucket. The Kidney Qi Pill is used to warm the Kidney Yang to restore its function of steaming fluid and transforming Qi, and the thirst can be relieved.
Recent literature shows that Jin Kui Kidney Qi Wan is commonly used in patients with chronic nephritis, chronic pyelonephritis, diabetic nephropathy, idiopathic membranous nephropathy, and advanced uremic syndrome of the spleen and kidney Yang deficiency type with relatively good efficacy. This formula can also reduce the complications caused by prednisone; and has a significant improvement on the symptoms of back pain in patients with kidney disease.
Warming Yang, resolving drinks, strengthening the spleen and promoting water retention
The twelfth book of the Jin Kui Yao (The twelfth book of the Jin Kui Yao): “When there is phlegm and cough under the heart, the chest is full and the eyes are dizzy, Ling Gui Jui Gan Tang is the mainstay.” “When there is micro-drink in short breath, it should be removed from the stool, Ling Gui Jui Gan Tang is the mainstay, and Kidney Qi Pill is also the mainstay.” Ling Gui Shu Gan Tang formula: Poria four two, cinnamon three two, white atractylodes three two, licorice two two). On the four flavors, to six liters of water, boiled to three liters, divided into three servings of warm, the urine is favorable.
This method deals with the evidence and treatment of phlegm and micro-drinking. The former article is about the weakness of the stomach and Yang, water and drink stay, so there is phlegm and drink under the heart, drinking evil internal obstruction, then the chest and full; clear Yang does not rise, then the eyes are dizzy. Micro-drinking refers to the slightest of water-drinking, that is, the so-called “water stopping under the heart, the micro short gas” evidence, micro-drinking disease, the external evidence is not obvious, only see short gas, seems to be mild, but water-drinking internal obstruction, Yang does not transform gas, its origin in the spleen and kidney, must be early for treatment. Water and drink stay and prevent the Qi from rising and falling, so short of breath. Yang Qi does not transform, so the urine is not good. However, the drink of evil, there is due to the Yang deficiency in the water stop for drink, its origin is in the spleen, must see the heart under the rebellious full, starting that is dizziness and other symptoms, the treatment with Ling Gui Zhu Gan Tang of Fu Ling water, Gui Zhi Tong Yang, white atractylodes to strengthen the stomach, licorice and. All the medicines are used to warm Yang and dissolve drinks, strengthen the spleen and promote water retention.
Currently, Ling Gui Zhu Gan Tang is mainly used in patients with hydronephrosis and chronic nephritis who are in the Yang deficiency and watery type. The clinical features of this formula include: dizziness and weakness, palpitation and shortness of breath, edema and oliguria, loss of appetite, nausea and vomiting, and cold pain in the chest and back.
Modern pharmacology confirms that Ling Gui Zhu Gan Tang mainly has diuretic, cardiotonic and anti-inflammatory and anti-allergic effects. Fu Ling, Gui Zhi and Atractylodes macrocephala extracts have obvious and long-lasting diuretic effects. Glycyrrhiza glabra has anti-inflammatory and anti-allergic effects; Gui Bark can inhibit complement immune hemolytic reaction and inhibit complex nephritis urine protein; Poria can improve the phagocytosis of mouse macrophages and inhibit the induction of autoimmune diseases. Ling Gui Zhu Gan Tang has good anti-inflammatory and anti-allergic effects.
V. Nourishing Blood, invigorating Blood, strengthening the spleen and relieving dampness
The 20th article of the Jin Kao Yao (The Golden Kernel): “When a woman is pregnant with a baby and has pain in the abdomen, Angelica Sinensis and Paeonia lactiflora are used. And 《Women’s Miscellaneous Diseases Pulse Evidence and Treatment XXII》：”For women with pain in the abdomen, Angelica Paeoniae Paeoniae Pantotrichum is the mainstay.” (Angelica paeoniae San: angelica three taels, peony one catty, rhizome F half catty, poria four taels, white atractylodes four taels, zedoary half catty, the above six flavors, crushed for the scattering, take the square inch dagger, wine and, three times a day)”.
Women’s abdominal pain in pregnancy and all diseases with angelica peony powder, although the treatment is not a kidney disease, but from the formula test evidence is a spleen deficiency and wet depression of kidney disease can be applied. At present, it is mainly used clinically to treat early diabetic nephropathy, chronic glomerulonephritis, and hydronephrosis belonging to spleen deficiency and dampness and blood deficiency and blood stasis.
Li Xiaobing [6] observed the therapeutic effect of Angelica paeoniae san on 72 patients with early stage glycogenic kidney, and the results showed that the 24-hour urinary protein and urinary albumin excretion rate (UAER) were significantly reduced in the treatment group, and the urinary albumin creatinine ratio decreased; IL-6, TGF-131, CRP, and IL-18 were significantly reduced after treatment. This study suggests that the addition of Angelica paeoniae powder may protect renal function and delay the progression of DN by attenuating the microinflammatory state in patients with early diabetic nephropathy. Chen Baoguo [7] treated 60 cases of renal colic with urinary tract stones using angelica peony san with yujin, money grass, white flowered snake tongue and licorice.
Sixth, dissolving drinks and moving water, diuresis and swelling
The twelfth book of “Jin Kui Yao Yao”: “Thirsty for water, water into the vomit, called water inversion, Wu Ling San main. and “the pulse is floating, the urine is unfavorable, slightly hot and thirsty, it is appropriate to facilitate urination and sweating, Wu Ling San is the mainstay” and “if a thin person has palpitations under the umbilicus, spitting saliva and d glare, this water is also, Wu Ling San is the mainstay.” Five Ling San formula: zedoary a minute, pig ling three points (remove the skin), Fu Ling three points, three points, white atractylodes, cinnamon two points (remove the skin). The above five flavors, for the end, white drink serving square inch dagger, three suits a day, drink more warm water, sweat out of the cure.
These three articles deal with the treatment of water rebellion. The bladder is out of order, the lower jiao water storage, the upper reverse and the stomach also stop water, the Jin is not on the cloth and thirsty, drink water is refused but not accepted, so the water into the vomit. If the phlegm drink in the lower jiao, not from the urine and go, but the bladder qi-transformation failure, the water has no way to go, reverse and upward, then vomit saliva and dizziness; water moving in the lower, the umbilicus palpitation rushing back, drink in the lower jiao, when from the urine to go, treatment with Wu Ling San to resolve the gas and water. If the surface evil is not relieved, heat can not be drained, bladder gasification is blocked, water stops in the lower, the fluid does not spread up and thirsty drinking, the treatment also uses Wu Ling San.
In modern times, this formula is used for nephritic edema, renal syndromic edema, diabetic nephropathy edema, cardiogenic edema, hepatic edema, endocrine disorders and idiopathic edema belonging to edema caused by bladder Qi-transformation disorder can be considered for application. Liu [8] reported that 42 cases of chronic glomerulonephritis with proteinuria were treated with Wu Ling San plus flavor, and the duration of the disease ranged from less than 1 year to 5 years, and the result was that 14 cases (33.3%) were effective (those who took less than 10 doses, urine protein turned negative and the symptoms disappeared); 24 cases (57.1%) were effective (those who took less than 20 doses), and the total effective rate was 90.4% (the duration of the disease in the invalid cases was more than 3 years). The total effective rate was 90.4% (the duration of invalid cases was more than 3 years). The results: 5l cases (77.27%) were cured, 10 cases (15.15%) were effective, 5 cases (7.58%) were ineffective, and the total effective rate was 92.42%. 92.42%.
The experimental study by Wang [10] showed that Wu Ling San extract had diuretic and antihypertensive effects on renal hypertensive rats without causing electrolyte disturbances. Gao’s [11] study found that Wu Ling San could significantly reduce the level of vascular endothelin, suggesting that it could improve the function of vascular endothelial cells by lowering the blood uric acid level. Yu [12] and others observed that both preventive and therapeutic administration of Yin Chen Wu Ling San could inhibit the increase of serum total cholesterol (TCH), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) content and LDL-C/HDL-C ratio in rats with hyperlipidemia model.
7. Light percolation and diuresis, nourishing Yin and clearing heat
The Twelfth Book of the Jin Kao Essentials: “For those with floating and feverish pulse, thirst for water, and unfavorable urination, pigling soup is the mainstay.” Pig ling soup formula: pig ling (peeled), poria, aconite, slippery stone, zedoary, one tael each. The above five flavors to four liters of water, first boil four flavors, take two liters, remove the slag, inside the gum melt elimination, warm serve seven, three times a day.
This article deals with the treatment of the evidence of urinary discomfort due to water-heat interconnection and heat-depression injury to yin. Floating and feverish pulse, thirst for water and unfavorable urination are symptoms of water-heat interlocking and injuring yin, therefore, pigling soup is used to promote water and nourish yin. In this formula, Erling, Zeligia and Slippery Rock are lightly permeable to promote water and clear heat, and Agaricus nourishes Yin and moistens dryness, so that water is removed and heat is not attached, and the thirst is relieved.
In modern times, it is mostly used for yin deficiency edema or. Among the 106 medical cases counted by Chen Ming [13], the vast majority of diseases treated by pigling soup were urinary system diseases, ranking in the top five: urinary stones, chronic nephritis, chronic pyelonephritis, celiac disease, and hydronephrosis. Wu Yixian [14] treated 60 cases of senile retention of urine with pigling soup as the main addition, and the treatment results showed that 56 cases were cured (the number of nocturnal urination was less than 2 and urination was smooth); 3 cases were improved (the number of nocturnal urination was reduced, and the symptoms of spot urination disappeared or reduced), and 1 case was ineffective.
Quan Shijian, Xiong Manqi et al [15] found through experiments that poria soup could effectively inhibit thylakoid cell proliferation and slow down the damage of renal function. Zhang Zuonian, Liu Huadong et al [16] used gardenia cypress poria soup to treat an experimental acute pyelonephritis model in rats and found that gardenia cypress poria soup could rapidly improve local inflammation and effectively inhibit the growth of bacteria in the urine and left kidney tissue of affected rats. Chen Ming and Guo Xuanxian [17] found that the serum of the compound formula of Jia Wei Pigling Tang could inhibit the secretion of IL-6 protein in MC induced by LPS, and its inhibitory effect was more significant at the peak of secretion and showed a dose-dependent relationship, suggesting that the inhibition of thylakoid cell proliferation by this formula may be related to the inhibition of thylakoid cell autocrine IL-6.
Promoting blood circulation, resolving blood stasis, eliminating Y and promoting water retention.
The “Jin Kui Yao”, “Women’s Pregnancy Diseases Pulse and Treatment XX”, said: “Women with Y disease, the menstrual break is not yet three months, but get more than leakage, the fetus moving on the umbilicus, for Y chronic harm. The first three months of menstrual water conservancy, the fetus also. The next blood, after the break in March bad also. So the blood is not only, the Y does not go to the reason, when the Y, Gui Zhi Fu Ling Pill main.” Gui Zhi Fu Ling pill formula: Gui Zhi, Poria, peony (go to the heart), peach kernel (go to the tip of the skin, boil), peony equal parts, the right five flavors of the end of the, refined honey and pills, such as rabbit shit big, take a pill every day before eating. If you do not know, add up to three pills.
This article deals with the treatment of Y disease in women. The formula measures the evidence of Gui Zhi to promote Yang and invigorate Blood, Fu Ling to promote water retention and subdue swelling, Dan Pi and Tao Ren to break stasis and subdue Y, and Paeonia lactiflora to harmonize Blood. The herbs are used together for blood stasis and edema. Modern treatment with this formula on diabetic nephropathy, chronic nephritis, purpuric nephritis, urinary tract stones, etc.
Pharmacological studies have found that rats given Gui Zhi Fu Ling Wan in a spontaneous diabetic model showed significant improvement in the indexes related to renal function. In addition, it has been shown that Gui Zhi Fu Ling Wan [18] has inhibitory effects on oxidative stress, glycation reaction and activation of polyol pathway caused by chronic hyperglycemia.
The components of Gui Zhi Fu Ling Wan formula have anti-inflammatory, reduce the viscosity of whole blood, enhance the deformability of red blood cells, improve the agglutination status of red blood cells, and inhibit platelet aggregation, and have better efficacy in isolated hematuria type or isolated proteinuria in purpura nephritis [19].
IX. Warming Yang, resolving blood stasis, and relieving dampness and toxicity
In the Jin Kui Yao Yao, “The pulse evidence and treatment of intestinal carbuncle and intestinal carbuncle infiltrates the 18th”: “The intestinal carbuncle is a disease, the body is wrong, the abdominal skin is urgent, and the pressure is moist, like swelling, there is no accumulation in the abdomen, there is no heat in the body, and the pulse is numbered, this is a carbuncle and pus in the intestine, and the Coix lacrymae and the sorrel is the mainstay.” The formula: sixty percent of Coix seeds, two points of sophora, five points of sophora, the right three flavors, pestle and pestle, take a square inch dagger, two liters of water, decoction reduced by half, and take. This formula is used for treating the symptoms of stagnation of Ying Qi, heat and Yang Qi deficiency.
This formula was originally used in treating intestinal canker sores with heat and toxin accumulation and Yang Qi deficiency. Intestinal carbuncle mainly refers to a condition in which the skin of the abdomen is tense and elevated like a swelling, but soft when pressed. The clinical evidence of Yang deficiency and cold dampness can be treated with Coix lacrymae and Fructus abscessus, especially in cases where cold dampness is heavy and Yang deficiency is light. Such as complicated urinary tract infection, chronic pelvic pain and other diseases.
The study of the pharmacological basis of C. coix seeds and sorghum showed that in vitro experiments on the active components of C. coix seeds and sorghum showed good free radical scavenging effect and antioxidant activity. A clinical study by Zhao Shi Kui [21] found that this formula was effective in chronic pyelonephritis. Lan Hongying et al [22] reported that the use of Coix lacrymae and Fructus septicum in combination with penicillin was effective in the treatment of renal abscess.
X. Warming Yang, dispersing cold, and dipping cold stagnation
Rhubarb and Radix Pseudostellaria Tang: Rhubarb three taels, Radix Pseudostellaria three (cannon), Hosanna two taels.”
This formula has the function of warming Yang, dispersing cold and dipping cold accumulation, and is a representative formula of warming down agents. Clinical studies have found that rhubarb and appendage soup can improve symptoms associated with chronic renal insufficiency, uremia, acute renal failure, diabetic nephropathy, and other diseases. Pang Li et al [23] treated 30 patients with chronic renal insufficiency by using Dahuang and Fengshi Tang with addition and subtraction, and the results showed a significant reduction in BUN and Scr in patients after treatment. Peng Bao et al [24] randomly grouped 45 patients with uremia and gave them rhubarb and epidermis soup and western medicine respectively, and the results showed that the efficiency of the Chinese medicine group was 80.9%, which was significantly higher than that of the control group (P<0.05). Lv Hongyi et al< span="">[25] treated diabetic nephropathy with rhubarb and epiphyllum soup with evidence, and after 2-3 courses, the 24-h urine protein quantification was reduced by more than 40% compared with that before treatment, and FBG, BUN, and Scr were significantly reduced.
The main active ingredients of rhubarb are anthraquinone derivatives, of which rhubarbin and rhubarbic acid have protective effects on the kidney. Rhubarb tannin inhibits the decomposition of protein in the body and reduces the absorption of amino nitrogen in the intestine, thus reducing blood urea nitrogen and creatinine; fine pine has antipyretic and analgesic, anti-rheumatic, anti-metabolic, antibacterial and anti-inflammatory effects, and can also inhibit the excretion of urinary protein in rats with nephropathy and improve serum biochemical indexes.
The author summarized the common prescriptions used in the treatment of renal disorders in the Jin Kui Yao, according to their frequencies, as follows: licorice (123 times), ginger (68 times), ephedra (54 times), poria (53 times), jujube (52 times), peony (49 times), rhubarb (46 times), epiphyllum (46 times), atractylodes (33 times), angelica (31 times), astragalus (21 times), etc. In Chinese medicine, kidney disorders are mostly classified as “edema”, “gonorrhea”, “guange”, “deficiency labor”, “retention of urine”, and “retention of urine”. “It is worthwhile for future generations to consider this in detail, as it is based on the protection of the lungs, spleen and kidneys, and on the identification of the main symptoms and side effects.