Chronic renal failure (CRF) is a serious clinical syndrome caused by progressive renal parenchymal damage due to primary or secondary chronic kidney disease of various causes, resulting in renal hypofunction, retention of metabolites in the body, imbalance of water, electrolyte and acid-base balance, and systemic involvement. The prevalence of chronic kidney disease in adults in China is 9.4%-13.6%, and the incidence is still increasing, reaching more than 7% per year. According to this projection, there are more than 100 million patients with chronic kidney disease in China, and if 1% of them develop into end-stage renal disease, the number of dialysis patients in China will reach 1 million.
I. Etiology and pathogenesis
Deficiency of the spleen and kidney and toxic evil are the key to the pathogenesis of CRF. Kidney deficiency is the intrinsic basis for the development of CRF, and is the root of toxic evil, while toxic evil stagnation of the three jiao is an important factor in triggering and aggravating the deterioration of kidney function.
Chronic renal failure is characterized by detoxification, detoxification and anti-toxic treatment.
According to the characteristics of the disease mechanism of spleen and kidney deficiency and the diffusion of toxic evil in the three jiao, the treatment principle of detoxification, detoxification and anti-toxicity is proposed. In other words, on the basis of strengthening the spleen and kidney, supporting the righteousness and anti-toxicity, oral detoxification is the main method, enema detoxification is supplementary, together with medicinal bath to disperse the toxin, compressing the umbilical cord to expel the toxin in four ways, multi-path to get rid of the toxin.
1, detoxification method
CRF is weak, dampness, water, stasis, phlegm poison diffuse, the clinical manifestations of poison retain the original pathogenic characteristics of the evil, treatment, should remove the original cause or pathogenic factors, so that the poison less attached, easy to decompose, that is, “detoxification” treatment. Clinically, for the differences of dampness, water toxicity, stasis toxicity and phlegm toxicity, by removing dampness and resolving turbidity, warming Yang and promoting water circulation, activating blood circulation and resolving stasis, regulating qi and resolving phlegm, so that qi and blood flow smoothly and ligaments are unblocked, then water, dampness, phlegm, stasis and toxicity will not be regenerated, that is, “treatment by examination of causes”.
2.Detoxification method
CRF poisonous evil diffusion, congestion and blockage of the qi, three jiao does not pass, resulting in detoxification dysfunction, internal poison stagnation in the body. At this time, we should take advantage of the situation, according to the different locations of the poisonous evil, near the guide, to give the poison a way out, to detoxification as the treatment, that is, “treatment of symptoms” method. The main methods include sweating detoxification, diuretic detoxification, laxative detoxification and navel detoxification.
(1) Sweating detoxification
Chinese medicine bath method is an ancient and unique treatment method in Chinese medicine. One of the therapies is to open and drain the dampness and toxicity from the deep to the shallow, with sweat; the second is to relieve the surface and promote the lung, to regulate the water channel, to reduce swelling; the third is to “open and channel the dampness and toxicity, to regulate the blood vessels so that there is no stagnation”, until a slight sweat can be. Suitable for people with chronic renal failure in all stages or with edema or itchy skin.
(2) Laxative detoxification
The method of laxative detoxification of the internal organs is a unique treatment method of Chinese medicine for CRF. It is applicable to different stages of CRF. Commonly used drugs are raw rhubarb, Citrus aurantium, etc., or Chinese medicine taken internally, or reserved enema. Rhubarb has become a specialized medicine for the treatment of chronic renal failure: modern research has confirmed that rhubarb can effectively treat chronic renal failure and slow down its development.
The principle is to imitate peritoneal dialysis to remove “drowning toxins” in the blood through diffusion and ultrafiltration.
(3) Diuretic detoxification
Chronic renal failure is characterized by internal stagnation of toxins, weakening of kidney energy, lack of power of bladder gasification, inability to expel toxins, or overflowing of water toxins to the skin, resulting in edema. The treatment is to warm the kidneys and strengthen the spleen, and diuresis and detoxification.
(4) Compressing the navel to expel toxins
The Shen Que point is one of the main points of the Ren line, which is the gathering point of all the veins and the tie of true qi. In addition, the skin of the Shen Que point is shallow and the drug penetration is strong, so the pharmacological effect of Chinese medicine can be fully exerted continuously. It is also effective in improving the symptoms by accelerating the local blood circulation and promoting the full absorption of drugs with the irradiation of Shen Que point.
3.Anti-toxic method
That is, by strengthening the spleen and tonifying the kidney to support the positive energy, regulating the qi, blood, yin and yang of the internal organs, improving the body’s own ability to resist toxicity, and reducing the degree of damage caused by toxicity to the body, that is, the method of “treating the root”. The main methods are.
(1) tonifying the kidney and filling the essence to strengthen the root
(2) To strengthen the spleen and stomach and regulate the elevation
(3) Strengthening the qi and the surface to prevent external evil
Patients with CRF are susceptible to external evil, resulting in complications such as colds, coughs and gonorrhea, and external evil is one of the important factors that trigger and aggravate the disease and accelerate the pathological process of CRF. Therefore, it is very important to use Yu Ping Feng San and other additions and decreases to benefit the Qi and strengthen the surface, harmonize the Ying and Wei, and prevent the external evil.
In the treatment of CRF, the anti-toxic method is a very important treatment method, especially to pay attention to strengthening the spleen and nourishing the latter, strengthening the spleen and strengthening the kidneys, cultivating the earth and generating gold, in order to enhance the anti-toxic ability and reflect the holistic concept of TCM.