Chronic renal failure (CRF) is the common outcome of the continuous progression of various renal diseases. It costs 50,000-60,000 RMB per year for hemodialysis and peritoneal dialysis, plus about 100,000-120,000 RMB per year for erythropoietin and hospitalization, which is a big financial burden for the society and the family.
How to slow down the process of kidney failure and improve the quality of life is an important issue in the field of kidney disease research. Our integrated treatment with oral Chinese medicine, enema, fumigation and ion introduction has played a positive role in slowing down the progress of CRF, delaying the arrival of dialysis and reducing the number of dialysis sessions, and improving the quality of life.
A. Understanding of the etiology and pathogenesis of CRF in Chinese medicine
CRF is mostly caused by the development of chronic kidney diseases such as “edema” and “gonorrhea” over time, and some of them have an insidious onset and are already in CRF when discovered. The spleen and kidney deficiency is the key to the pathogenesis of CRF, throughout the CRF.
II. Treatment
(I) Identification and treatment
Referring to the “Guidelines for Clinical Research on New Chinese Medicines for Chronic Renal Failure” issued by the State Food and Drug Administration in 2002, the treatment is divided into the original deficiency and the evil reality.
1. Original deficiency
(1) Qi deficiency of spleen and kidney.
Main symptoms: tiredness and fatigue, shortness of breath and lazy speech, little food and dullness, lumbar acidity and knee weakness.
Secondary symptoms: distention and fullness, insubstantial stools, light mouth, light tongue with teeth marks, sunken pulse. Mostly seen in the early stage of azotemia. The treatment is to strengthen the spleen and tonify the kidney, with Xiang Sha Liu Jun Zi Tang and Right Return Drink plus reduction. The medicine uses 15g of Radix Codonopsis, 15g of Poria, 12g of Atractylodes Macrocephala, 6g of Glycyrrhiza, 12g of Pericarpium Citri Reticulatae, 12g of Fuxia, 6g of Sharen, 5g of Cordyceps, 15g of Eucommia, 12g of Fructus Lycii, and 20g of Salvia.
(2) Spleen and kidney yang deficiency evidence.
Primary symptoms: coldness in the extremities, tiredness and lassitude, shortness of breath and lazy speech, little food and dullness, lumbar soreness and knee weakness.
Secondary symptoms: cold pain in the lumbar region, distension and fullness in the epigastrium, insubstantial stools, nocturnal urination, pale tongue with teeth marks, sunken and weak pulse. Mostly seen in the azotemia or renal failure stage. The treatment is to warm the spleen and kidney, and the formula is combined with Real Spleen Drink and Zhen Wu Tang plus or minus. The medicine uses Poria 15g, Atractylodes macrocephala 12g, Radix et Rhizoma Atractylodis Macrocephala 6g, Cao Guo 10g, Ginger 10g, Betel nut with skin 20g, Licorice 6g, Radix Codonopsis pilosulae 20g.
(3) Spleen and Kidney Qi-Yin deficiency.
Main symptoms: tiredness and fatigue, lumbar soreness and knee weakness, dry mouth and throat, five heartburn. Secondary symptoms: clear and long nocturnal urination, pale tongue with teeth marks, sunken and thin pulse. Mostly seen in the azotemia phase. Treatment is to benefit qi and nourish yin. The formula is supplemented with Da Teng Yuan Decoction with 10g of American ginseng, 15g of fried yam, 10g of Shu Di, 12g of Du Zhong, 12g of Fructus Lycii, 10g of Cornu Cervi Pantotrichum, 6g of Licorice, 10g of Angelica Sinensis, 15g of Bei Qi.
(4) Liver and kidney yin deficiency evidence.
Primary symptoms: dizziness, headache, lumbar soreness and knee weakness, dry mouth and throat, five heart troublesome heat.
Secondary symptoms: dry stool, yellow urine, light red tongue with little coating, sunken or thin pulse. Mostly seen in the early stage of azotemia. The treatment is to nourish the liver and kidney, with the formula of Liu Wei Di Huang Wan with Er Zhi Wan plus or minus, using Shu Di 24g, Dan Pi 12g, Ze Di 10g, Shan Yao 15g, Fu Ling 12g, Zhen Zhen Zi 12g, Dry Lotus Grass 15g, Dan Shen 30g, Cornu Cervi Pantotrichum 10g.
(5) Evidence of deficiency of both yin and yang.
Main symptoms: awe of cold extremities and cold, five heartburn, dry mouth and throat, lumbar acidity and knee weakness.
Secondary symptoms: nocturnal urination, dry stool, pale tongue with teeth marks, sunken pulse. Mostly seen in renal failure. The treatment is to treat both yin and yang, with Jin T Kidney Qi Pill plus reduction, using 20g of Shu Di, 15g of Yam, 12g of Cornu Cervi Pantotrichum, 6g of Radix et Rhizoma Polygonati, 3g of Cinnamon, 10g of Dampi, 10g of Ze Di, 15g of Poria, and 5g of Cordyceps.
2. Standard Evidence
(6) Dampness and turbidity evidence.
Main symptoms: nausea and vomiting, heavy limbs, little food and dullness.
Secondary symptoms: distention and fullness of the abdomen, mucousy mouth, thick and greasy tongue coating. Most often seen in the uremic phase with acidosis or gastrointestinal dysfunction. Treatment: To clear the internal organs and lower the turbidity. The formula uses warm gall bladder soup plus or minus, with Chen Pi 10g, Fa Xia 12g, Fu Ling 15g, Su Ye 12g, Cao Guo Ren 12g, Huo Xiang 10g, Zhu Ru 10g, Da Huang 6g, Sha Ren 8g after the next, Cang Zhu 10g, ginger 5 slices, licorice 6g.
(7) Damp-heat evidence.
Main symptoms: nausea and vomiting, heavy and sleepy body, little food and dullness, dry mouth, bitter mouth. Secondary symptoms: distention and fullness of the abdomen, mucousy mouth, yellow tongue coating, mostly seen in uremia with encephalopathy. The treatment is to clear heat and resolve dampness. The formula is based on Huang Lian Wenzhi Tang with addition and subtraction, using Huang Lian 10g, Wu Ju Ju 6g, Chen Pi 10g, Sha Ren 10g, Su Ye 8g, Citrus aurantium 10g, and Zhu Ru 6g.
(8) Water-Qi Evidence
Main symptoms: Edema, hydrothorax, ascites. The treatment is to promote water retention and eliminate swelling. For Spleen-Qi deficiency, use Fangji Huangqi Tang; for Spleen-Yang deficiency, use Real Spleen Drink; for Kidney-Yang deficiency, use Ji Sheng Kidney Qi Pill or Zhen Wu Tang plus or minus.
(9) Blood stasis evidence
Main symptoms: dull complexion, back pain.
Secondary symptoms: skin and nails are wrong, numbness of limbs, purple and dark tongue or petechiae, astringent or fine pulse. Treatment: Promote blood circulation and resolve blood stasis. If Yang deficiency of blood stasis is accompanied by water-dampness retention, use Gui Zhi Fu Ling Wan plus or minus; if Yin deficiency of blood stasis is present, use Xue Fu Xiang Yu Tang plus or minus; if Qi deficiency of blood stasis is present, use Tonic Yang Hui Wu Tang plus or minus.
(10) Wind movement evidence
Main symptoms: twitching of the hands and feet, convulsions and spasms.
Treatment: Dispel wind and suppress spasm. If liver yang turns into wind, use Antelope and Hooked Vine Tang with addition and subtraction; if phlegm generates wind, use Radix Bupleuri and Tianma Tang with addition and subtraction.
(II) Our experience
Although CRF can be divided into the above-mentioned five types of deficiency and three types of symptoms. However, among the five types of original deficiency, the deficiency of spleen and kidney qi (yang) gradually leads to the failure of spleen and kidney as the central link, and among the deficiency and failure of spleen and kidney, the key is to regulate the spleen, not to tonify the kidney. In the case of standard reality, the turbid toxin is blocked, and the turbid toxin differs between cold and heat depending on the body type. The degree of CRF varies between the deficiency and the actual condition, and the severity is different.
Therefore, the main treatment for CRF is to strengthen the spleen, tonify the kidney, lower the rebellion and detoxify the turbidity. Commonly used drugs: Chen Pi 12g, Jiang Han Xia 12g, Fu Ling 15g, Sha Ren 10g later, Cardamom 12g, Dan Shen 30g, Da Huang 12g, Su Ye 12g, Bei Qi 30g, Dang Shen 15g, Gan Jiang 12g, Chuan Huang Lian 12g, Lycium barbarum 12g.
Professor Ye Rengao used his own formula “Nourishing Kidney Soup” to slow down the progression of CRF and reduce the number of replacement therapy. Herbs: Ginseng 10g, Radix Bacopa Monnieri 10g, Herba Cistanches 10g, Fructus Lycii 10g, Radix et Rhizoma Polygonati 10g, Radix Rehmanniae 20g, Poria 20g, Epimedium 15g, Salviae Miltiorrhizae 30g, Radix Astragali 30g, Semen Aesculi 30g.
(C) Experience of famous veteran Chinese medicine practitioners and experts in combined Chinese and Western medicine
1, Professor Ye Rengao used his own formula “Nourishing Kidney Soup” to slow down the progress of CRF and reduce the number of substitution therapy with good effect. Medicine: Ginseng 10g, Radix Bacopa Monnieri 10g, Herba Cistanches 10g, Fructus Lycii 10g, Radix Aconiti 10g, Radix Rehmanniae 20g, Poria 20g, Epimedium 15g, Salviae Miltiorrhizae 30g, Radix Astragali 30g, Semen Aesculi 30g.
2. Xu Songnian formulated Warming Kidney and Detoxifying Soup [30g of Perilla, 15g of Radix Codonopsis, 15g of Atractylodes Macrocephala, 9g of Radix Panax, 3g of Huanglian, 30g of Junxue, 30g of mung beans, 30g of Salvia, 9g of Radix Rehmanniae (first decoction), 9-15g of Rhizoma Eucommiae, 3g of Sharen (later down), 6g of ginger] for the treatment of uremia.
3.Zhang Qi ①Transforming dampness and detoxifying Blood to treat the symptoms: a Fang transforming dampness and dampness, bitter cold and draining heat method. Basic formula: Rhubarb, Huanglian, Scutellaria, Herba Cauliflower, Huo Xiang, Atractylodes, Perilla, Chen Pi, Semen, Ginger, Sand, Licorice, decoction in water, 1 dose daily. b Clearing heat and detoxifying the Blood to treat the symptoms, detoxifying and invigorating the Blood with the addition of Radix Angelicae Sinensis, Rhizoma Polygonati, Rhizoma Safflower, Licorice, Salviae Miltiorrhizae, Radix Paeoniae, Radix Angelicae Sinensis, Radix Puerariae Sinensis, Radix et Rhizoma Chai Hu, Citrus Aurantium, decoction in water, 1 dose daily.
②Benefit Qi and Blood to nourish the spleen and kidney to cure the root. Commonly used drugs: Atractylodes macrocephala, Poria, Yam, Radix Rehmanniae, Astragali, Radix et Rhizoma Ginseng, Semen Cuscutae, Radix Angelicae Sinensis, Fructus Lycii, Cornu Cervi Pantotrichum, Radix Glycyrrhiza Uralensis, Radix et Rhizoma Sanguisorba, 1 dose in water.
③Tonic for the spleen and kidney to drain dampness and detoxify blood, treating both the symptoms and the root cause. Basic medicine: Red ginseng, Atractylodes macrocephala, Poria, Cuscuta, Radix Rehmanniae, Rhizoma Polygoni, Rhizoma Rheum, Radix et Rhizoma Gramineae, Semen, Peach kernel, Safflower, Salviae Miltiorrhizae, Radix Paeoniae, Radix Glycyrrhiza, taken with water decoction, 1 dose daily.
(IV) Single medicine treatment
Cordyceps, rhubarb, salvia, Chuanxiong and other mono-medicinal drugs have positive efficacy in the treatment of CRF.1. Cordyceps and its preparations Bailing capsule and Ningxinbao capsule are suitable for CRF lung and kidney qi deficiency, which have positive efficacy in promoting the repair of renal tubular epithelial cells, reducing the damage of gentamicin and other drugs on renal tubular interstitium, improving the perfusion rate of glomerulus and reducing the damage of glomerulus. Usage: Bailing capsule 5-8 capsules, 3/day, orally; Ningxinbao capsule 2 capsules, 3/day, orally.
2.Rhubarb is suitable for CRF with evil real mainly or mixed with deficiency real, with dry stool as the main symptom feature. Rhubarb to strengthen the excretion of intestinal toxins, especially nitrogen; correct the imbalance of trace elements in the body; improve the level of amino acids in the blood, the use of ammonia synthesis of protein, inhibit the decomposition of protein in the body; hemostatic effect, improve the bleeding tendency of CRF. Usage: Rhubarb capsule 0.75~3g per day, divided into 3~4 times orally, 3~6g per day under raw rhubarb after, 5~10g per day for manufactured rhubarb is appropriate.
3.Danshen is suitable for those with hypercoagulable state in the early stage of CRF. Danshen can improve the hypercoagulable state, increase the blood flow in the kidney, and promote the repair of glomerular injury, the common dose is 15~30g per day, or 20~30ml of Danshen can be added into 5% glucose 250ml in the IV once a day for 14 days.
4. Chuanxiong is mainly used for CRF with hypercoagulable state. It has the ability to improve intrarenal perfusion, increase endogenous creatinine clearance, inhibit intestinal Gram-negative bacilli, reduce toxins produced by intestinal bacterial decomposition, antioxidant, inhibit thylakoid cell proliferation, and delay the progression of CRF. Usage: Tablets 2~3 tablets, 3/day, orally; into soup 10~15g per day; or Chuanxiongzine injection 100~160mg, add 5% glucose 250ml in IV, once a day, 14 days for a course.
5. Lanosterium has the ability to improve intrarenal blood supply, increase glomerular filtration rate, reduce glomerular immune damage, and strengthen the repair of glomerular damage. How to use: 50~100mg in 5% glucose 250ml IV, once a day, 14 days for a course.
(E) Preserved enema with Chinese medicine
Prescription: 30g of raw rhubarb, 30g of calcined oyster, 30g of dandelion, 20g of sophora.
Usage: Decocted into 100~150ml, 1 time per night, high retention enema, 20 days for 1 course of treatment.
Effects: ① rhubarb in the formula to increase the excretion of intestinal toxins, especially urea nitrogen ② calcium supplementation to lower phosphorus: oyster in the formula mainly contains calcium combined with phosphorus in the intestine, forming a complex to prevent the absorption of phosphorus in the intestine to lower phosphorus, free calcium is absorbed to correct the low calcium in the blood ③ rhubarb and dandelion inhibit intestinal bacteria, reduce toxins produced by intestinal bacteria, ④ promote the synthesis of protein from nitrogen in the body, inhibit the decomposition of protein ⑤ supplementation trace elements to correct the imbalance of amino acid metabolism.
(F) Chinese herbal medicine bath therapy
Prescription: Ephedra, Gui Zhi, Su Ye, Phyllanthus, Qiang Wu, Dou Wu, Fang Feng, Chuan Xiong, Angelica, Safflower, Yimu Cao, Eucommia, each 30g, Chuan Wu 20g, Hesperidin 10g.
How to use: Pour the concentrated decoction of Chinese herbs into the fumigating machine, adjust the temperature to 50-70℃ and fumigate for 30 minutes. For those who do not have a fumigating machine, add the decoction to half a bathtub with appropriate amount of water to cover the body when lying down, soak for 15-30 minutes each time to achieve the purpose of sweating, so as not to feel fatigue after fumigation or bathing. Once a day, 2 weeks for a course of treatment, rest 5 days. Usually 2~3 courses of treatment.
Effects: Sweating, promote the excretion of toxins in the blood from sweat, can reduce creatinine and urea nitrogen in the blood, improve kidney function. It is the method of “opening the door of ghosts” in Chinese medicine. It is a kind of skin dialysis method.
(7) External application of Chinese medicine and ion introduction
1. External application of Chinese medicine to acupuncture points
Prescription: Siberian tablet, Xianling spleen, peach kernel, Chuanxiong, safflower, incense, etc.
Then, use 1.9% of Gui-An-En solution to mix the powder, wrap the powder in gauze and apply it to the bilateral kidney and Guan-Yuan points, then moisten the powder with 1.9% of Gui-An-En solution every day.
2.External application of Chinese medicine to the umbilicus
Prescription: Radix et Rhizoma, Radix et Rhizoma, Radix Astragali, Radix et Rhizoma Yiwu, etc.
3.External application of Chinese herbal medicine to the kidney area
Prescription: Yimu Cao, Chuanxiong, Safflower, Eucommia, Turbinate, Salvia, 30g each
4.Chinese herbal medicine ion introduction
Prescription: Chuanxiong, safflower, dulcimer, rhubarb, etc.
How to use: Decoction of the above medicine and ionization treatment in the kidney area.
(viii) Chinese medicine treatment for common complications of CRF.
1. Hypoproteinemic malnutrition: CRF patients have a long-term low-protein diet, nausea and vomiting when acidosis occurs, reduced food intake, and loss of 5-15 g of protein per day in patients with abdominal dialysis and 10-30 g of peptides and amino acids per day in patients with hemodialysis, resulting in hypoproteinemia. It is manifested as the evidence of deficiency of both spleen and kidney and deficiency of qi and blood. Treatment is to strengthen the spleen, tonify the kidney, benefit the qi and nourish the blood.
Use Ginseng Nourishing Glory Soup with Addition: Poria 15g, Yam 20g, Atractylodes 15g, Radix Angelicae Sinensis 12g, Radix Paeoniae Alba 12g, Pericarpium Citri Reticulatae, Ginseng 10g, Radix Astragali 30g, Radix Rehmanniae 12g, 10g Cinnamon 3g, Grain Bud 30g, Wheat Bud 30g, Chicken Neijin 10g. 1 dose daily with water decoction. This formula is better for increasing appetite and raising plasma protein. Generally after 2 months of treatment, the plasma protein gradually rebound, if you can match the effect of medicinal food treatment is better.
2. Pruritus.
CRF patients are common. The skin is dry and itchy, flaky, ichthyosis-like, throughout the trunk and limbs often scratching and see the skin broken, affecting sleep. The diagnosis is mostly due to blood deficiency, dryness, heat and wind, the treatment is to nourish the blood, moisten dryness and dispel wind.
Radix Angelicae Sinensis 15g Shengdi 20g Paeonia lactiflora 15g Chuanxiong 10g Gymnema sylvestre 30g Salviae Sinensis 20g Zhi Mu 12g Thornbush 12g Fang Feng 12g Cicadelle 12g Bai Xian Pi 15g Ocimum sanctum 15g Xu Changqing 10g, 1 dose daily with water decoction.
3. Renal bone disease.
CRF calcium and phosphorus metabolism disorders, such as osteochondrosis, etc.. The evidence belongs to the liver and kidney deficiency, blood stagnation, the treatment is intended to nourish the liver and kidney, strengthen the tendons and bones, blood circulation and blood stasis, prescription: Eucommia 15g Mulberry 20g Chuan Xiansheng 15g Fructus Lycii 15g Tortoise Board (first decoction) 15g Myrrh 12g Wu Ling Lip 12g Oxalis 12g Oyster 30g.
All CRF have different degrees of anemia. The use of erythropoietin (EPO) is effective in renal anemia, and if combined with traditional Chinese medicine, the dosage of EPO can be reduced and the efficacy can be improved. The treatment is to strengthen the spleen, tonify the kidney, and benefit the qi to nourish the blood.
The formula is Ginseng and Paeoniae Sijunzi Tang Plus: Ginseng 15g Astragalus 30g Poria 12g Atractylodes 12g Dried Herbs 6g Angelicae 12g Paeoniae 12g Antler Gum 30g 1 dose daily with water decoction. After 4 weeks of medication, hemoglobin began to rise.
(ix). Chinese medicine treatment of peritoneal dialysis complications.
4, renal anemia :
1. abdominal pain and distension: a common complication of CAPD. Abdominal pain can be caused by poor quality of dialysis fluid, too much fluid intake, too fast fluid intake or drainage, and too cold dialysis fluid; inadvertent air input during fluid intake can also cause abdominal distension. The treatment is to strengthen the spleen and disperse cold, move Qi and relieve pain.
The formula is based on the following formula: Radix Codonopsis pilosulae 15g, Poria, Atractylodes macrocephala, Rhizoma atractylodis Macrocephalae, Rhizoma Houpa, Mucuna Pruriens, Xuanhu, Clove, Cumin, 12g each, Glycyrrhiza glabra 6g. 1 dose daily with water decoction. Clinical observation, except for abdominal pain caused by peritonitis, generally take 3-5 doses of abdominal distension and abdominal pain can be relieved. This formula can strengthen gastrointestinal motility, so it can also prevent Tenckhoff’s canal from functional obstruction in the abdominal cavity.
2, peritonitis.
It is a more serious complication in peritoneal dialysis. There is often fever, abdominal pain and refusal to press, abdominal muscle tension, turbid permeate, and pathogenic bacteria can be cultured. The diagnosis is dampness and toxicity, invasion of Shaoyang and stagnation of Qi and blood.
In addition to the use of antibiotics in the dialysis fluid or systemically, the treatment is often combined with the reconciliation of Shaoyang, moving Qi and blood, clearing heat and detoxifying the toxin, with the formula of Dachaihu Tang with Addition: 12g each of Chaihu, Scutellaria baicalensis, Citrus aurantium, Fa Xianxia, Red and White peony, Xuanhu, 10g Rhubarb, 30g Silver Flower, 20g Dandelion. 1 dose daily with water decoction.
3. Diarrhea.
Patients with spleen and stomach deficiency, kidney yang weakness, if cold and drinking cold, then watery stools, 5-10 times a day. If the spleen is deficient in moisture, use Ginseng and Atractylodes Plus: 12g each of Astragalus, Radix Codonopsis, Poria, Atractylodes, Atractylodes, 30g each of Yam, Gorgonian, Coix seed, 15g of Plantago ovata, 6g of sand, 15g of pomegranate peel.
If the diarrhea is prolonged and does not change, it is a deficiency of the spleen and kidney yang, the formula is Rizhong Tang and Si Shen Wan with added flavor: 15g of Radix et Rhizoma Ginseng, Atractylodes Macrocephala, Poria, 12g of Ginger, Fructus Psoralea, Cornus Officinalis, Nutmeg, Poppy Shell, 30g of Yam, 6g of Wu Wei Zi, 1 dose daily with water. Usually take 3-5 doses to stop the diarrhea.
4, hyperlipidemia.
Long-term abdominal dialysis patients, can develop hyperlipidemia. The diagnosis is liver and kidney deficiency, phlegm and dampness stagnation, blood stagnation, treatment is intended to nourish the liver and kidney, cleanse phlegm and eliminate turbidity, activate blood circulation and eliminate blood stasis.
Prescription: Shan Jie 30g Danshen 30g Yu Zhu 15g Huang Jing 15g Cassia 15g Yin Chen 15g Ze Xie 12g Yin Hua 15g Da Huang 8g. 1 dose daily with water decoction.
(X). Chinese medicine treatment of hemodialysis complications.
1. Dialysis imbalance syndrome.
CRF starts several times in maintenance hemodialysis patients, with rapid clearance of metabolites in the blood after dialysis, while metabolites in the brain parenchyma and cerebrospinal fluid are restricted by the blood-brain barrier concentration decreases slowly, thus forming a difference in osmotic concentration between plasma and cerebrospinal fluid, allowing water to enter the brain tissue, resulting in cerebral edema and increased cerebrospinal fluid pressure.
Symptoms: nausea, vomiting, headache, anxiety, hazy eyes, drowsiness, poor appetite, and yellow tongue coating. In Chinese medicine, the symptoms are due to spleen deficiency and stomach rebellion, with dampness and turbidity disturbing the upper part of the body. Treatment is to strengthen the spleen and stomach, dampness and turbidity, formula with Huang Lian Diagolang with flavor: Huang Lian 10g Chen Pi 10g Fa Han Xia 10g Poria 12g Citrus aurantium 10g Fried Bamboo Ru 10g June Snow 30g Plantago ovata (another) 15g Rhubarb 10g Su Ye 12g Ginger three slices , 1 dose daily, decoction with water.
2, hypotension.
There are many reasons for hypotension caused when blood is made, such as insufficient blood volume, ultrafiltration dehydration too fast, long-term use of sodium carbonate or sodium acetate dialysis can cause peripheral vasodilatation, decreased resistance, lower blood volume, etc. Symptoms: lack of warmth in the extremities, panic, shortness of breath, cold sweat, dry mouth and desire to drink, weak pulse. The executive intends to benefit qi and nourish yin, and immediately add 30-60ml of raw pulse injection to 150-200ml of 5% glucose intravenous drip.
3. Pericarditis.
In patients with maintenance hemodialysis, the incidence of pericarditis is 10-15%, with dry or exudative or even hemopericarditis. The cause may be related to viral infection, heparin use, inadequate dialysis, disease factors or hyperparathyroidism, etc. Symptoms: chest tightness, chest pain, form of cold, less breath and lazy speech, pale face, even shortness of breath can not lie down, blue lips, thin pulse or knot generation.
The evidence belongs to spleen and kidney Yang deficiency, phlegm and turbidity blockage. Treatment is to wet yang and water, phlegm and turbidity, prescription: Gui Zhi 10g Poria 20g Atractylodes Macrocephala 10g Pieces of Atractylodes 10g Bacopa Monniera 10g Cistanches 10g Astragalus 20g Semen 10g Chen Pi 10g Citrus 10g Calamus 10g Rhubarb 10g.
(XI). Dietary therapy.
Choose a diet low in protein, low in phosphorus, high in calcium and high in calories. Increase fish and use vegetable oil in cooking to help prevent arteriosclerosis. Avoid oranges, bananas, shiitake mushrooms, fungus and squash when high in potassium. Egg yolk, meat loaf and animal offal, brain and bone marrow contain more phosphorus and should not be eaten in excess. You can eat more food containing high calcium and low phosphorus such as snail, sesame, lotus root powder, cabbage, celery, cabbage, tomatoes, melons, sugar cane, apples, etc.
The patient is not allowed to eat peaches, cold, spicy, fatty, sweet and thick taste, avoid overeating. Limit the intake of water and sodium when urine is low.