Introduction to Experience in Treating “Proteinuria” 1980.12.14

Introduction to Experience in Treating “Proteinuria” 1980.12.14

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1. Emphasize clearing and draining—eliminating pathogenic factors while supporting vital energy.

The prescription contains numerous herbs that clear heat, detoxify, disperse wind, and drain dampness. At the same time, it can also be combined with methods to tonify the kidneys and strengthen the spleen. Some patients, after ineffective treatment with warming yang to promote water metabolism and strengthening the spleen to transform dampness, achieved significant therapeutic effects by using heat-clearing and detoxifying agents. Commonly used herbs include seven-leaf one-branch flower, white-flowered snake-tongue grass, dandelion, houttuynia, and cicada slough.

2. Attach importance to regulating the functions of the lung, spleen, and kidney.

(1) Open the lung qi: Ephedra is used for acute cases, while Perilla leaf is used for chronic cases; the dosage can be increased up to 30 g.

(2) Regulate the spleen qi: The term "regulate" should encompass both "tonify" and "move." To tonify the spleen, use Codonopsis, Atractylodes, and Astragalus; among these, Atractylodes should be used in larger quantities. To move the qi, use Agarwood, Amomum, Areca nut, and Magnolia bark.

(3) Tonify the kidney qi: Both yin and yang should be supplemented. In addition to using Liuwei Pill and Jin Gui Shen Qi Wan, other herbs such as Rosa laevigata, Rubus idaeus, Schisandra chinensis, Ginkgo biloba, Prunus mume, and Cinnamomum cassia can also be used.

Kidney-strengthening formula: Used for patients with mild edema, only proteinuria, or slight renal impairment. Cicada slough 10 g, Leonurus cardiaca 30 g, small thistle 30 g, Polygonatum odoratum 20 g, Eucommia ulmoides 10 g, walnut meat 15 g, Psoralea corylifolia 10 g, Rubus idaeus 30 g, Asarum 3 g.

Mnemonic: Yellow Du, fine meat coat (benefit), small basin, bone marrow ten grams—divine efficacy.

Kidney-clearing formula: Used for stubborn proteinuria accompanied by hematuria but without obvious edema. Use 30 g each of Lysimachia christinae, Equisetum arvense, Leonurus cardiaca, Hedyotis diffusa, and Radix Rehmanniae, along with 10 g of cicada slough, 15 g each of Semen Trichosanthis, Cuscuta chinensis, and Dryopteris crassirhizoma, and 8 jujubes.

Mnemonic: Heavenly silk, earth, gold, cicada slough—three herbs and Dryopteris reduce egg-like protein.