One Insight on Treating Chronic Nephritis, August 30, 1999

One Insight on Treating Chronic Nephritis, August 30, 1999

In the summer of the Yi Mao year, I treated Wang from the Lanzhou Academy of Sciences, who had suffered from chronic nephritis for two years, with persistent proteinuria (++ to +++). He had previously experienced hematuria, casts, hypertension, and edema. After taking Jisheng Shenqi, Guizhi Fuling, Yishen, Sugeng, Chantui, and Leonurus cardiaca—a total of 60 doses—the proteinuria turned negative. However, due to a cold relapse, the proteinuria increased again to (+++), and subsequent treatment with the same formula did not show significant improvement. Upon reflection, I realized that long-term kidney tonification can harm the spleen and stomach, and insufficient middle qi leads to a lack of kidney qi. At this point, as Li Dongheng said, "It's better to strengthen the spleen than to tonify the kidneys." Therefore, I combined Bashan Huangtu Decoction with Sugeng, Chantui, and Leonurus cardiaca, and after seven doses, the proteinuria decreased to (++). Further administration reduced it to (+). Later, I added Shiting Baiyin Dasaogin and Dandelion Bajiangcao with Fangfeng, and after another seven doses, the proteinuria completely disappeared! This case demonstrates that when treating chronic nephritis, if the effect of kidney-tonifying therapy stalls after a period, it is advisable to switch to spleen-strengthening formulas: Bashan Compound, Shiwei, Tingli Zi, Baizhi, Yinchen, Dahuang, and Zaoguaci.