How do doctors combine Chinese and Western medicine to treat nephrotic syndrome?

  The involvement of TCM in the treatment of nephrotic syndrome has been recognized by connoisseurs. During the high-dose hormone period, children experience the side effects of hyperphagia, irritability, sweating, and poor night sleep, and Chinese medicine can significantly improve these symptoms by nourishing Yin and subduing Yang and lowering fire; during the low-dose hormone maintenance treatment phase, protein is prone to recurrence, and Chinese medicine can reduce recurrence by helping to dispel evil; during the hormone discontinuation phase, Chinese medicine can maintain nephrotic remission by enhancing the hypothalamic pituitary adrenal axis. Since Professor Liu Baohou of Gansu College of Traditional Chinese Medicine proposed phased treatment of nephrotic syndrome, this therapy has basically become a model of combined Chinese and Western medicine for the treatment of kidney disease. This therapy is introduced below.  (1) Initial stage: Due to the high dosage of hormones, the children mostly have manifestations of liver and kidney yin deficiency, such as redness and dizziness, night sweats, poor night sleep, and often accompanied by damp-heat stagnation or external wind-heat manifestations. It is advisable to nourish yin, clear heat, submerge yang and lower fire, if necessary, with the method of clearing heat and dampness, dispel wind and pass through the ligament can enhance the therapeutic effect of hormones. Medicine: Six-bit Dihuang Pill, Zhi Bai Dihuang Pill, Mai Wei Dihuang Pill, with Damp-Heat and Wind Evil, add Bai Hua Shi Tong Cao, Half Branch Lotus, Pierced Mountain Dragon, Qing Feng Vine, Cicada Miao, Yi Mu Cao, Shi Wei, Curcuma longa, etc.  (2) Dose reduction phase: Due to the withdrawal of hormones, patients often show evidence of deficiency of both qi and yin. Fatigue, weakness, weakness of the waist and knees, dizziness and tinnitus, easy to catch cold, light red tongue and fine pulse. The treatment should be to nourish both qi and yin, nourish the liver and kidney, activate blood circulation and remove blood stasis, and gradually reduce the products of clearing heat and dipping fire and increase the flavor of benefiting qi and nourishing kidney to reduce the degree of cortical suppression by exogenous hormones. Medicinal uses: raw astragalus, prunus ginseng, raw earth, lady’s mantle, dry lotus herb, pierced mountain dragon, white hyssop, stone wormwood, salvia, motherwort, cicada molasses.  (3) Maintenance phase: At this time, most of the patients are in remission of nephrotic syndrome, and most of them show deficiency of spleen and kidney, while a few of them show deficiency of both qi and yin. In order to prevent relapse or rebound, it is advisable to reduce the nourishing Yin products and strengthen the taste of tonifying the kidney and strengthening the spleen, so as to improve the immunity of the body, promote immune regulation, enhance cellular immunity and antibody formation. The use of warming the spleen and kidney, invigorating blood circulation and resolving blood stasis can further consolidate the therapeutic effect, prevent colds, eliminate relapses and reduce the occurrence of withdrawal syndrome to ensure smooth withdrawal of hormones. Herbs: Astragalus membranaceus, Radix Codonopsis pilosulae, Salicornia sinensis, Phyllostachys sinensis, Semen cuscutae, Poria, Rhizoma coptidis, Radix et Rhizoma ginseng, Radix et Rhizoma cicada. The pathological type of those who fail to completely remit or only partially remit with hormone therapy is mostly not microscopic lesion type, but mostly other pathological tissue types. Since the disease is persistent and stasis is bound to occur after a long period of time, it is advocated that on the basis of benefiting Qi and tonifying the kidney, products that activate blood circulation and resolve stasis should be used, and supplemented with heat-clearing and detoxifying flavors to clear immune complexes. Chinese herbs to activate blood circulation and remove stasis (Salvia miltiorrhiza, Panax notoginseng, Yimoucao, Zeilan, Curcuma longa, etc.) can not only reduce the high viscosity state of blood, but also improve the effect of fibrinolytic disorders, which should be implemented throughout the treatment.  Liu Baohou advocates the use of hormones, second-line drugs, platelet depolymerizers and Chinese medicine in quadruple combination for the treatment of nephrotic syndrome. It also focuses on the following four principles: First, the principle of combining macroscopic and microscopic disease identification with evidence identification. Second, focus on eliminating evil, clearing heat and dampness, and activating blood circulation to remove blood stasis. It is proposed that “if damp-heat is not removed, protein is difficult to eliminate; if blood stasis is not removed, kidney energy is difficult to restore”, and it is advocated that when damp-heat is not removed, the use of warm tonic products should be avoided. Third, invigorate the blood and open the channels to delay kidney failure. In each stage of benefiting Qi, tonifying the kidney, strengthening the spleen, and clearing damp-heat, we cooperate with blood activation and stasis removal to increase renal blood flow and promote fibrinolysis, so as to minimize the pathological damage to the kidney. Fourth, dual diagnosis of Chinese and Western medicine, organic combination of Chinese and Western medicine. When applying the standard course of hormone therapy, the corresponding traditional Chinese medicine is combined with different stages of hormone application organically to minimize the side effects of hormone, enhance the therapeutic effect, shorten the course of disease, reduce recurrence, prevent rebound, and also effectively prevent the occurrence of hormone withdrawal syndrome.