3. Treatment for Chronic Glomerulonephritis

3. Treatment for Chronic Glomerulonephritis

Chronic glomerulonephritis is a common and frequently occurring disease, often affecting children and adolescents, with no significant difference in incidence between males and females. Most cases of chronic glomerulonephritis result from prolonged or improperly treated acute nephritis; however, some cases do not have a history of acute illness. The full name of this disease is chronic glomerular nephritis, as its pathological changes involve the deposition of antigen-antibody complexes in the basement membrane of the glomerular capillaries. Over the past half-century, the classification and subtypes of chronic glomerulonephritis have evolved several times: initially divided into hypertensive type, nephritic type, and mixed type; later, within the nephritic type, those without high blood pressure, with severe edema, elevated triglycerides, and low calcium levels were classified as nephrotic syndrome; subsequently, cases where urine contains only a small amount of occult blood, without detectable proteinuria or a slight increase in microalbumin in 24-hour urine were labeled as focal nephritis (or chronic glomerulonephritis with microscopic lesions). In summary, with the advancement of medical science, our understanding of chronic glomerulonephritis has steadily increased, and new classifications and subtypes have emerged. In recent years, the incidence of "acute progressive nephritis" has been rising year after year, and the number of patients with renal failure has also been increasing. Our understanding of chronic glomerulonephritis is undergoing fundamental changes—self-immune pathogenic mechanisms play a crucial role in the onset of various forms of nephritis. This is precisely where a fundamental transformation in the concept of nephritis treatment is brewing, and undoubtedly, this will help us overcome this long-standing health challenge that has plagued humanity.

Traditional Chinese Medicine and herbal remedies for chronic glomerulonephritis are rooted in discussions about conditions such as "edema," "phlegm-fluid," and "water-dampness." I believe that Zhang Jingyue's writings, drawing from the Inner Canon, the Golden Chamber Essentials, and the great achievements of ancient sages, provide valuable reference for clinical treatment of chronic glomerulonephritis. Zhang said, "Water is the ultimate yin, its origin lies in the kidneys; water transforms into qi, its manifestation lies in the lungs; water fears earth, its treatment lies in the spleen." Zhang believed that the key to treating edema lies in strengthening the spleen and promoting water metabolism—methods like the Wuling Powder, the Wupí Yin, the Shishi Yin, the Linggui Zhigan, the Zhenwu Tang, and the Fuzi Tang all rely on strengthening the spleen to promote water metabolism. Although water retention due to yang deficiency in the kidneys is caused by weakened kidney yang, the yang of the kidneys relies on the yang of the spleen to warm and nourish the body—only then can yang flourish and water be properly regulated! Thus, the yang of the spleen and the yang of the kidneys truly complement each other! This is precisely what is meant by "spleen-kidney yang deficiency" in traditional Chinese medicine.

After years of experience, I have found that patients with chronic glomerulonephritis who experience edema accompanied by dizziness, lower back pain, leg discomfort, cold hands and feet, and spontaneous sweating often also exhibit facial swelling, a heavy and fatigued complexion, loss of appetite, weakness, little energy, and abdominal distension with loose stools—these are clear signs of spleen-yang deficiency. Conversely, patients with spleen-yang deficiency often display facial pallor, a lack of appetite, fatigue, and a tendency to speak in a low voice, along with abdominal distension and loose stools. These findings indicate that spleen-yang deficiency is indeed a common clinical manifestation of chronic glomerulonephritis. Therefore, the use of formulas like Wupí and Wuling in the treatment of chronic glomerulonephritis is a valuable contribution to clinical practice.

I typically employ the following five methods to treat chronic glomerulonephritis, which will be discussed in detail below.