2. Chronic Nephritis

2. Chronic Nephritis

<!-- translated-chunk:15/57 -->

The occurrence of this disease is often associated with dysregulation of the body's immune homeostasis. Due to this dysregulation, the body loses its ability to distinguish "self" from "non-self," mistakenly identifying its own tissues as foreign substances and producing corresponding antibodies, thereby triggering an abnormal immune response. Specifically, the body treats the glomerular basement membrane as an antigen, generating antibodies that bind to the basement membrane and form antigen-antibody complexes. Under the promotion of complement activation, inflammatory reactions ensue, leading to tissue damage in the renal parenchyma. This is an abnormal immune response primarily driven by specific immunity, yet non-specific immunity also plays a role. Traditional Chinese Medicine does not have a specific term for nephritis; however, based on syndrome differentiation, it falls under the category of "edema." Ming Dynasty scholar Zhang Jingyue stated: "All cases of edema are diseases related to the spleen, lungs, and kidneys. Water is the essence of yin, so its root lies in the kidneys; water transforms into qi, so its manifestation lies in the lungs; water fears earth, so its control lies in the spleen. When the lungs are weak, water fails to transform into essence and instead becomes water; when the spleen is weak, earth fails to control water and instead overcomes it; when the kidneys are weak, water has no master and runs amok." This indicates that the manifestation of this disease resides in the lungs, its root lies in the kidneys, and its control lies in the spleen. Edema is further divided into yin edema and yang edema: the former is more commonly associated with the spleen and kidneys, characterized by deficiency and cold; the latter is more commonly associated with the lungs, characterized by excess and heat. Clinically, the latter resembles acute nephritis, while the former resembles chronic nephritis. Thus, the key pathological features of chronic nephritis still lie in the spleen and kidneys. In TCM treatment, strengthening the spleen involves using Buzhong Yiqi Tang with modifications; strengthening the kidneys involves using Jisheng Shenqi Wan with added herbs—these measures happen to be effective in regulating both non-specific and specific immunity. In 1965, at a national symposium on chronic nephritis held at the Institute of Traditional Chinese Medicine, it was proposed to focus on the pathogenesis of spleen-kidney dysfunction as the primary classification criterion, dividing cases into "kidney-yang deficiency type" and "kidney-yin deficiency type." Following this classification, Liaoning College of Traditional Chinese Medicine treated 100 cases of chronic nephritis with a dual-tonifying approach targeting both the spleen and kidneys, achieving complete remission in 33 cases, near-complete remission in 13 cases, partial remission in 39 cases, for an overall effective rate of 85%. The PLA’s 281st Hospital reported on combined traditional Chinese and Western medicine treatment of 110 cases of chronic nephritis, with herbal formulas mainly focusing on tonifying the kidneys and strengthening the spleen. Clinical cure was achieved in 67 cases, accounting for 60.9%; near-cure in 15 cases; improvement in 17 cases, resulting in an overall effective rate of 90%. The PLA’s 51st Hospital used Dangshen, Baizhu, Huangqi, Shanyao, and Fuling to strengthen the spleen, and Rougui and Fupian to tonify the kidneys, in combination with Western medicines to treat 14 cases of nephrotic syndrome. The results were: complete remission in 9 cases, near-complete remission in 4 cases, and significant improvement in 1 case. These data demonstrate that treating chronic nephritis with the method of strengthening the spleen and tonifying the kidneys can indeed achieve good therapeutic effects. It seems even more accurate to understand this issue by examining the regulatory effects of this method on the immune system.