Chronic glomerulonephritis is a common consequence of multiple pathological types of primary glomerular diseases, in the course of the disease, is an autoimmune disease, the specific causes of the disease are mostly not self-knowing. Suffering from this disease, it seriously affects the work and study of patients and makes the quality of life decrease, and timely and symptomatic treatment is the only scientific option for patients. The characteristics of this disease are: more long-term hypertension, edema; persistent abnormal urine routine examination, moderate to severe amount of proteinuria, urine sediment (especially erythrocyte tubular and glomerular erythrocytes); mild impairment of renal function and slow non-stop progression; the kidneys may have symmetrical shrinkage; X-ray confirmed diagnosis of the renal pelvis and calyces and other collection system is normal; confirmed exclusion of other diseases caused by secondary chronic glomerulonephritis.
The chronic glomerulonephritis pathological damage, mostly proliferative and sclerotic lesions, in clinical hypercoagulable state, so it can be inferred that chronic nephritis from the beginning to the end of the blood stasis exists. Therefore, blood activation and elimination of blood stasis has been the main therapy for chronic nephritis and has significantly improved the efficacy. This may be due to the fact that activating blood stasis can improve glomerular filtration function. The commonly used drugs for activating blood circulation and removing blood stasis are Salvia miltiorrhiza, Radix Paeoniae, Radix Angelicae Sinensis, Saffron, Rhizoma Chuanxiong, Yimoucao, Momordicae Sinensis, and Zelenia leaf. The degree of hematuria, proteinuria, hypertension and renal hypofunction in chronic nephritis is related to the TCM evidence.
For example, liver and kidney yin deficiency is mostly seen in the hypertensive type of chronic nephritis; qi and yin deficiency is mostly seen in the common type of chronic nephritis; those with hematuria, proteinuria, hypertension, and azotemia manifestations, the pathological type is mostly seen in thylakoid proliferative nephritis, membranoproliferative nephritis, and focal segmental glomerulosclerosis; spleen and kidney yang deficiency is highlighted by proteinuria and is mostly accompanied by moderate to severe swelling, which is equivalent to the nephrotic type of chronic nephritis, and the treatment should be western medicine The treatment should be based on western hormones or cytotoxic drugs. When starting to use large doses of hormones, there is often medical hypercorticism, which is in line with the kidney-yin deficiency in TCM, and with TCM treatment, it can improve the body’s general condition and enhance the efficacy. Mild proteinuria is the main manifestation of the spleen and kidney qi deficiency type, which is equivalent to the common type or nephrotic type of chronic nephritis, and the pathological type is mostly seen in microscopic lesions or lgA nephropathy.
Chronic glomerulonephritis belongs to the category of “deficiency labor”, “edema” and “lumbago” in Chinese medicine according to its clinical manifestations. The disease process is slowly developing, so throughout the course of the disease, the positive qi and the disease waxes and wanes, resulting in the complexity of the disease mechanism and variable symptoms. Therefore, chronic nephritis is based on the deficiency of both spleen and kidney, interspersed with edema, dampness, heat and blood stasis. The pathological pattern of chronic nephritis is first injury to Qi and then loss of Yin, which has a certain relationship with the stage of its pathological damage, so attention to Qi deficiency, Qi and Yin deficiency stage of evidence-based treatment measures, for the prevention and treatment of primary glomerular disease and prevention and delay the arrival of renal failure is of great significance.
From the identification and treatment of Chinese medicine is divided into five types.
1, spleen and kidney deficiency without edema type The main manifestations are: soreness and weakness of the waist and knees, dizziness, fatigue, laziness, lack of breath and speech, lack of color, poor appetite and loose stools, pale tongue with white coating and weak pulse. Since this type is mainly due to spleen deficiency, the treatment should be to strengthen the spleen and benefit the kidney.
2, spleen and kidney yang deficiency edema type The main manifestations are: edema of the limbs and even the whole body, lumbar acidity and cold limbs, pale face, loose stools, little urine and clear color, light fat tongue, white greasy moss, and sunken thin pulse. Treatment is to warm the kidney and promote water.
3.Yin deficiency of liver and kidney, dampness and heat are mainly manifested as: dizziness and tinnitus, lumbar soreness and leg weakness, bitter mouth and dry throat, insomnia, yellow and red urine or astringent pain, or blood in urine, or mild swelling of limbs, red tongue with little coating and thin pulse. Treatment is to nourish the liver and kidney, clear heat and dampness.
4.Qi and Yin deficiency type The main manifestations are: sore back and spermatorrhea, slight or no swelling of the limbs, palpitation and shortness of breath, lack of color, fatigue or dryness of the throat and mouth, red tongue with little coating, thin pulse or hematuria. As this type of disease has caused deficiency of both qi and yin over a long period of time, the treatment is to tonify qi and nourish yin.
5.The main manifestations are: lumbar pain fixed or stabbing pain, dark gray face, dry skin, or petechiae, petechiae, decreased urine volume, swollen limbs, purple tongue or petechiae, astringent and sunken pulse or fine count. This type of disease for a long time, long-term disease into the complex, Qi disorder, water and dampness within the stagnation, blood stasis blockage, treatment should be to support the righteousness and expel evil, remove blood stasis and open the complex.
The actual fact is that you can find a lot of people who have been in the business for a long time. However, when there is hypertension or edema, salt and water intake should be limited. Protein intake can be as usual, and it is advisable to choose high-quality protein, such as chicken, money, lean meat, eggs and other animal proteins. Although shrimp, crab and other seafood are nutritious, but after eating it is easy to allergic, and nephritis is an autoimmune disease, so it should be eaten sparingly.
In terms of life, it is important to prevent colds and other infections, and to have high blood pressure treated promptly. As the kidneys have a strong compensatory capacity, when the kidneys are damaged by the disease, although only 25-35% of the remaining normal tissue, individual patients can still live and work normally without feeling tired, and even for the relevant blood biochemical examination can be no abnormal findings.
However, the reserve capacity of the kidney is very poor at this time, and it does not have enough ability to regulate water and electrolyte imbalance. Therefore, patients should be careful not to overeat, especially not to consume too much vegetable protein at once, such as peanuts, soybeans and their products, and not to take Chinese and Western medicines indiscriminately, especially not to listen to doctors and the so-called folk remedies and prescriptions. Because they may damage the kidneys. Western drugs that are damaging to the kidneys, such as gentamicin, X-ray contrast drugs, etc. In Chinese medicine, such as mucuna pruriens, zedoary, and rehmannia, etc., are also damaging to the kidneys. Even when patients are seeing other doctors, they must tell the doctor that they are already a patient with chronic nephritis to avoid the doctor using drugs that are damaging to the kidneys.
There are significant differences in the course of chronic nephritis with or without complications (especially hypertension). It can take 10 or more years from the first detection of urinary abnormalities to the development of renal failure, and once more pronounced azotemia develops, it progresses more quickly to renal insufficiency.
The following factors can accelerate the development of azotemia in chronic nephritis into chronic renal failure
1. The more severe the hypertension, the more severe it is
2. Failure to properly control protein intake in the diet
3. Dietary failure to control the intake of phosphorus
4.Infection
5, the use of nephrotoxic drugs. In order to determine the nature of the glomerular lesion in chronic nephritis, it is best to have a kidney biopsy, which is good for estimating the prognosis. In addition, the reciprocal of the patient’s blood creatinine value is used as a vertical coordinate and the time as a horizontal coordinate to draw a curve that can predict the rate of development of their renal impairment.
If you have the misfortune to suffer from this disease, choose the combination of Chinese and Western medicine treatment will be relatively good, (rather than a mixture of Chinese and Western treatment, that is, after seeing a Western doctor, and then go to a Chinese doctor), so that you can avoid the problem of Chinese and Western medicine and organic cooperation, will originate from Western medicine, higher than Western medicine; originate from Chinese medicine; higher than Chinese medicine, often to get the effect of complementary.
The following dietary therapy for chronic nephritis is attached.
1, gravy white fruit porridge: gravy 30 grams, white fruit 6, after shelling, add glutinous rice 50 grams, slow cooking porridge. Once a day, you can add sugar or a little salt.
Indications and contraindications: It is suitable for chronic nephritis with deficiency of positive energy and persistent proteinuria, and can be consumed intermittently for a long time. Those who have elevated blood urea nitrogen or blood creatinine should not take it.
2, lotus seeds gravy lean meat soup; lotus seeds 30 grams, gravy 30 grams, lean meat 100 grams, add water to boil soup, can add a little salt, with slag to serve.
Indications and contraindications: Suitable for chronic nephritis dietary supplements.
3, Cordyceps stewed duck: old male duck (or water duck) a (remove the hair and viscera), Cordyceps 20 grams, put into the duck belly, add water stewed, put a little salt, drink soup and eat dregs.
Indications and contraindications: For people with chronic nephritis and long-term mild proteinuria.