From the perspective of modern medicine, the pathological mechanism of chronic glomerulonephritis, as an immunoreactive disease, lies in the inflammatory changes such as cell infiltration, edema, and hyperplasia in glomerular capillaries and interstitium. These changes often result from the activation of complement by antigen-antibody complexes deposited in the glomerular capillary basement membrane, triggering a cascade of immune responses and inflammatory processes. However, when we look at this disease from the perspective of traditional Chinese medicine, we will find that there is a deeper etiology and pathogenesis behind it.
Traditional Chinese medicine theory believes that the problem of edema is "rooted in the kidneys". As the innate foundation, the kidney is the main water metabolism, and its normal function is directly related to the balance of water metabolism in the human body. If the kidney qi is sufficient, the water metabolism will be smooth, and vice versa, it will lead to an imbalance in the water metabolism and symptoms such as edema. In cases of chronic glomerulonephritis, kidney qi imbalance is often the underlying cause of edema.
Kidney Qi imbalance will first affect the spleen's function. Traditional Chinese medicine believes that the spleen is the main transport, transporting the subtleties and dampness of the water valley, and converting it into qi and blood to nourish the whole body. However, when the kidney qi is out of balance, the spleen loses its warmth and nourishment, and its function restricts water and dampness. It's like a water pump that loses power and can't effectively deliver water to where it's needed, causing water to accumulate in the body and form edema.
At the same time, kidney qi imbalance can also affect the bladder's gasification function. As the terminal organ of water metabolism, the normal vaporization of the bladder is directly related to the production and excretion of urine. When the kidney qi is insufficient, the bladder lacks the warmth of the kidney qi, and the gasification effect is weakened as a result. This is like a boiler with insufficient power, which cannot heat the water enough to convert it into urine and excrete it from the body, resulting in water retention in the body and edema.
Based on the above understanding, the idea of TCM in the treatment of chronic glomerulonephritis is to reconcile kidney qi and dissolve the source of water and dampness. Specifically, you can start from the following aspects:
1. Nourish kidney qi. By selecting drugs that have the effect of nourishing kidney qi, such as rehman, yam, and yam meat, the function of kidney qi can be enhanced, so that it can normally promote the metabolism of water and liquid.
2. Strengthen the spleen and promote dampness. While nourishing kidney qi, it is also necessary to pay attention to strengthening the spleen and promoting dampness. By selecting drugs that have the effect of strengthening the spleen and promoting dampness, such as Atractylodes, Poria cocos, Ze Yuan, etc., the spleen can be enhanced and the discharge of water and dampness can be promoted.
3. Warm the bladder. In view of the weakening of bladder gasification function, drugs with bladder warming effect, such as cinnamon, aconite, etc., can be selected to enhance the bladder gasification function and promote the production and discharge of urine.
Fourth, syndrome differentiation and treatment. In the process of treatment, it is also necessary to carry out syndrome differentiation and treatment according to the specific condition and physical characteristics of the patient. For example, for patients with kidney yang deficiency, drugs that warm and replenish kidney yang can be used; For patients with kidney yin deficiency, drugs that nourish kidney yin can be used.
In short, the idea of TCM in the treatment of chronic glomerulonephritis is to reconcile kidney qi and dissolve the source of water and dampness. By nourishing kidney qi, strengthening the spleen and dampness, warming the bladder and other methods to restore the balance of water metabolism, so as to achieve the purpose of treating edema. At the same time, in the process of treatment, it is also necessary to pay attention to syndrome differentiation and treatment, and individualized treatment is carried out according to the specific condition and physical characteristics of patients.
I am He Xuehong, a professor of Chinese medicine, and if you have any questions related to kidney disease, please leave a message to me in the comment area.