In the treatment of nephrotic syndrome in Chinese medicine, there are some very experienced old Chinese doctors in the country. Their experiences are worthy of our study and transmission. Below I upload some experienced prescriptions and comments of famous old Chinese medicine doctors. (Mainly extracted from the third edition of “Specialized Treatment of Pediatric Diseases” prepared by our department. I. The following formula I use for the first onset of kidney disease, mainly manifested as edema of the extremities, and is relatively mild, with vomiting, abdominal distension and other digestive system manifestations. For heavy edema, you can add Astragalus membranaceus 13 to 30 grams, or Radix et Rhizoma Polygonati 5 to 10 grams. Pediatric Kidney Disease Combination for Spleen Deficiency and Dampness Trapped in Kidney Disease (Old Chinese Medicine Doctor Li Shao Chuan, Affiliated Hospital of Tianjin University of Traditional Chinese Medicine) Ingredients: 9g of young sage, 10g of made Hou Pu, 6g of Guang Chen Pi, 6g of fried Atractylodes Macrocephala, 9g of fatty Zhi Mu, 9g of Yun Fu Ling, 10g of drawn Hu Lu, 9g of fried Citrus Aurantium, 9g of Mai Men Dong, 9g of pig ling, 9g of Ze Di, 6g of licorice. Directions: Put the above medicine into a container. Soak in cold water for 20 minutes, then decoct for 30 minutes on a light fire, take 120-150ml, divided into two warm doses. Indications: Pediatric nephrotic syndrome and swelling caused by spleen deficiency. Pediatric nephrotic edema is caused by deficiency of spleen and dampness, and failure of qi-transformation in Sanjiao. The spleen and stomach live together in the middle jiao and are the pivot of qi lifting and lowering, the main water and dampness is spread, stops and becomes water, overflows in the skin and develops into water. Children’s internal organs are young and tender, especially vulnerable to damage, so every clinical see this disease. The main point of treatment is not only dryness, seepage, and benefit, but also to strengthen the spleen, which is the fundamental treatment, and “Nei Jing” clearly teaches “open the ghost door”, “clean the internal organs”, and “go to Ivana Chen s” as the purpose of treating edema. Most of the methods of treating edema in later times have followed the ancient teachings of “Nei Jing” and have been cut down, so its source is also one. It is better than over-injection of gardenia and mucuna pruriens, which are bitter and dry and injure yin; to go to Ivana Chen s is to cleanse the intestines and stomach, so that the spleen can maintain normal accommodation and decomposition, so that the diffused water can return to the meridian. The addition of Zhi Mu and Mai Men Dong can complement the dryness of Bai Zhu on the one hand and the Yin of the stomach on the other. Li Shao-chuan often used this formula to tailor it to the symptoms, and it was effective in every case. Animal experiments have shown that this formula is effective in raising plasma protein, lowering urine protein and cholesterol. Add and subtract: when feeling wind-heat, coughing and sore throat with fever, remove Perilla stems and Atractylodes, add Peppermint, Thornbush spike, Forsythia, Goldenseal; when feeling wind-cold and seeing fear of cold, body heat and cold extremities, add Qiangwu, Fangfeng, Perilla leaves; when the positive qi is deficient and suffering from seasonal evil, add Prince’s ginseng, Pueraria Mirifica, Chaihu, imitating Ginseng Defeat Poison, in order to support the positive and dispel the evil; when the disease is prolonged and both qi and yin are injured, or when taking hormones for a long time, the face is red and fire rises. When Yin deficiency and Yang hyperactivity, can remove Atractylodes, Poria, reuse Zhi Mu, Mai Men Dong, or with Sheng Di Huang to moisten and nourish Yin. Pediatric nephrotic syndrome caused by edema, the clinic is quite difficult, to be in the clinical power to change, not to stick to a method of a party, wet and sticky, it is difficult to get quick results, the doctor should not be ignorant. Li Shaochuan used this formula and it worked repeatedly because of the reason that he did not forget to change it in the midst of persistence. (Chai Guozhao, Li Zhiwen, Wu Xiuxian, eds. The essence of contemporary Chinese medical prescriptions. (Changchun: Changchun Publishing House, 1993.468) Second, the following formula is mainly used in the process of taking hormones, when the fever, sore throat, cough and relapses, it has a better effect, even without increasing the amount of hormones. If combined with an increase in urine protein, 30 to 50 grams of cornus can be added. Note that Caulis Alba should not be taken for a long time because of its minor toxicity. Kidney disease and lung clearing soup for kidney disease with external evil trapping the lung and flooding with water (Liu Pilchen) Ingredients: Xuan Shen 10g, Panax notoginseng 10g, Shan Dou Gen 5g, Fishy grass 15g, Plantago ovata 15g, Inverted grass 15g, Yimou Cao 15g, Lampsquarters 1g. Indications: Pediatric kidney disease, acute and chronic nephritis, etc. Symptoms include swelling, oliguria, with nasal congestion and runny nose, unfavorable throat, cough with phlegm in the throat, etc. How to use: 1 dose daily, 2 times with water decoction, can be divided into several doses and finished on the same day. This formula is based on Liu Bichen’s original Fishy Herb Soup, which has been further reduced and modified. In this formula, Xuan Shen, Ban Lan Gen and Shan Dou Gen clear the throat and clear the portal of the lung. Fishy grass and plantain clear the lung, diuretic and reduce swelling. Yi Mu Cao activates blood circulation, diuresis and swelling. The herb is used to clear the lungs and promote diuresis, and to reduce swelling. The combination of all the herbs can clear the lung and promote pharynx, diuresis and swelling. Add and subtract: for nasal congestion and runny nose, add 10g of Cynanchum spp. and 10g of Cang Er Zi; for sore throat, add 10g of Jin Dang Guo and 10g of Qing Guo; for cough with phlegm, add 10g of Mulberry Bark, 10g of Ground Bark and 10g of Southern Ginseng; for superficial deficiency and excessive sweating, add 15g of Radix Astragali, 10g of Bifeng and 10g of Fried Atractylodes; for heavy edema, add 10g of Mulberry Bark, 10g of Poria Bark and 1g of Ginger Bark. (Rice) Yiyi Osprey, ed. The first batch of national famous old Chinese medicine practitioners to give the secret recipe selection – sequel. (Beijing: China Today Publishing House, 1999. 386) Third, the following formula is generally used for consolidation treatment during the remission period of kidney disease, where the dose of hormone is relatively small, about 2 tablets or less, and should not be accompanied by obvious damp-heat. If it is accompanied by damp-heat, you can add heat-clearing and dampness-relieving drugs to this formula. Beneficial Kidney and Spleen Soup for Nephrotic Spleen and Kidney Deficiency (Ma Lian Xiang) Composition: Astragalus membranaceus 12g, Radix Codonopsis pilosulae 9g, Rhizoma Atractylodis Macrocephalae 9g, Rhizoma Yam 9g, Glycyrrhiza Glabra 4g, Poria 9g, Zeligia 9g, Shi Wei 9g, Fructus Crataegi 9g, Salviae Miltiorrhizae 9g, Cornelian Flesh 9g. How to use: One dose daily, decoction of first decoction and second decoction, divided into two warm doses in the morning and evening, 10 days as a course of treatment. Indications: Nephrotic syndrome. Symptoms: lumbar soreness and limb fatigue, fatigue and poor circulation, loose stool and urine, lack of facial color, white tongue coating and sunken pulse. Explanation: This formula emphasizes the use of Huang Qi to benefit Qi and promote water retention, and help the spleen to restore its function of transportation and transformation. Radix Codonopsis, Rhizoma Atractylodis Macrocephala and Glycyrrhiza Glabra tonify the spleen and benefit the qi. Zegeolus, Shiwei and Che Qian Zi help to promote water and dampness to open the channels. Danshen tonifies blood and moves blood stasis, so that water can injure blood. If kidney disease is accompanied by anemia, it is often prolonged and not easy to heal, so cornelian benefits the kidneys and helps to promote water without hurting Yin. Chinese yam and wild hawthorn can help restore the spleen’s transportation and promote early recovery of the sick body. Addition and subtraction: This formula is effective in treating nephrotic syndrome smoothly, treating both the root and the symptoms, but if you see the face [ ] white, fear of cold, the extremities are not warm, is a deficiency of kidney yang, add Xian Ling Spleen 9g, Bacopa Monnieri 9g, light sophora 3g; see the dry throat, dizziness, eye astringency is a deficiency of kidney yin, add Mo Qian Lian 15g, Fructus Chasteberry 10g, Fructus Lycii 10g, raw and ripe Di Huang 10g each, 1 to 3 flavors. (Li Baoshun, ed. Famous doctors’ famous prescriptions. (Beijing: Chinese Medicine Ancient Books Publishing House, 1991.3) Fourth, if damp-heat occurs when taking drugs for the spleen and kidneys, it is necessary to change the formula, you can refer to the following famous old Chinese medicine experience formula, the role of the formula is mainly to clear heat and dampness. The case of famous veteran TCM doctor Zhao Xinbo: the child with kidney disease was stabilized after using the medicine to strengthen the spleen and dampness, but two months later, due to boils on the head and playful overwork, the swelling recurred and the urine protein increased again to (＋＋＋＋), with thin yellow tongue coating center and slippery pulse, and the dampness was not purified. The heart and lung heat is prevalent, that is, the agent to clear heat and benefit the bladder is given. Plantago ovata 10g, Yun Ling 12g, Tribulus terrestris 12g, Chrysanthemum 10g, Fried Gardenia yi 5g, Scutellaria baicalensis 6g, Mucuna pruriens 5g, Poria 10g, Perilla stems 6g, Betel nut 6g, Lantern flower 2.4g, Temperate bamboo leaf 5g. V. This following formula is generally used for the recurrence of renal disease at low doses of hormones due to the development of cough bronchitis (hot cough) with mild eyelid and extremity swelling with with proteinuria. Edema in nephropathy formula for the treatment of adverse lung qi in nephropathy (He Shiying) Composition: Mulberry Bark 15.6g, Dagong Pi 18.8g, Guang Chen Pi 9g, Ginger Pi 9g, Ephedra 9g, Dong Gua Pi 25g, Poria Pi 25g. Usage: Decoction in water to be taken frequently at warmth or in two doses. Nephrotic syndrome, swelling of the face and limbs, distention and fullness of the stomach and abdomen, upper gas and wheezing, unfavorable urination and scrotal swelling. Explanation: This formula is made up of Five Peel Drink with Ephedra and Dong Gua Pi. Ephedra is used to propagate the lung, calm asthma and promote water circulation, together with mulberry peel to propagate lung qi and regulate water channels. Ginger peel pungently disperses watery evil, Da Gua Pi down the gas and water, Poria peel permeates dampness and strengthens the spleen, Chen Peel regulates qi and harmonizes the middle, Dong Gua Peel promotes water and reduces swelling. This formula adds ephedra to promote the lung qi on the basis of Wu Pi Drink, and when the qi moves, the water moves, so the treatment of high edema in nephrotic syndrome is more effective than Wu Pi Drink alone. Diuresis starts on the fifth day after taking this formula and reaches its climax on the eighth day. (Xu Zhengang, ed. He Shiying’s Medical Cases. (Ningxia: Ningxia People’s Publishing House, 1979.241) Sixth, the following formula is generally used during high-dose hormone therapy with evidence of fever, heat in the hands and feet, irritability, hyperactivity of the stomach, poor night sleep, and night sweats. Basic prescription: Radix et Rhizoma 15g, Cornus Officinalis 9g, Radix et Rhizoma Dioscoreae 12g, Radix Mudanpi 17g, Poria Cocos 12g, Radix Zelenia 9g, Phellodendron Bark 6g, Radix et Rhizoma Chrysanthemum 9g, Radix et Rhizoma Lonicerae 12g, Radix et Rhizoma Drynariae 12g. 1 dose daily with water decoction. Addition and subtraction: for poor appetite, add 3g of sand, 5g of Chen Pi to awaken the spleen and regulate Qi; for stasis, add 15g of motherwort, 15g of hyssop, 12g of Salvia miltiorrhiza to activate blood circulation and resolve blood stasis; for damp-heat, add 15g of white flowered snake tongue grass, 7g of mountain gardenia, 15g of cornus to clear heat and dampness; for yin deficiency and fire, reuse raw groundnut, Zhi Mu, dry lotus grass to nourish yin and lower fire. For nourishing Yin and submerging Yang, use Phellodendron Bark, Zhi Mu, Turtle A, Turtle Board, etc.