One case of traditional Chinese medicine treatment of nephrotic syndrome in children, the syndrome belongs to: Qi deficiency and blood stasis, exogenous wind-heat type

Medical record: The patient, female, 6 years old, first visit. Chief complaint: intermittent edema of both lower extremities for 1 year. One year ago, the patient went to another hospital due to fever and cough, and was given intravenous infusion of “azithromycin” for 3 days, and then the symptoms were relieved and he was discharged from the hospital. One week later, abdominal distension and lower extremity edema occurred, which was diagnosed as “nephrotic syndrome”. Prednisone 5 tablets/d was given orally, but there was no obvious relief.

Now come to our hospital for further treatment and consultation. Immediate symptoms: fatigue, poor resistance, easy to catch a cold, mild edema of eyelids and lower limbs, but no discomfort. Satisfaction and sleep can be achieved, diuresis is adjusted, the tip of the tongue is red, the root of the moss is white and greasy, and the pulse is slippery and rapid.

Auxiliary inspection

Repeated urine routine examination showed: urine protein (+ ~ + + +), urine occult blood (++ ~ +++), 24-hour urine protein quantification: 1.13 ~ 2.15 g. Renal biopsy 4 months ago showed mild mesangial proliferative glomerulonephritis with tubulointerstitial injury.

Chinese and Western medicine diagnosis and diagnosis basis

The patient’s pathology report is clear, combined with symptoms such as fatigue susceptibility and urine protein examination, Western medicine diagnoses nephrotic syndrome. TCM diagnosis: Kidney water, the syndrome belongs to qi deficiency and blood stasis, exogenous wind and heat.

Fourth, intervention

Treating method: replenishing qi and activating blood, clearing heat and expressing expression

Prescription: Raw Astragalus, Angelica, Notopterygium, Yizhiren, Salvia, Moutan Cortex, Radix Paeoniae Rubra, Polyporus, Poria cocos, isatis root, cicada slough, silkworm, licorice.

Usage: 7 doses, 2 times a day, morning and evening. Nursing care: Breakfast is small but refined, 1 bag of milk;

V. Outcome

During the follow-up consultation, the patient’s perceived fatigue improved significantly, and his resistance improved. Dark color with foam, occasional frequent urination, no other discomfort. Na Mei Ke, smooth stool. The tip of the tongue is slightly red, the coating is white and slightly greasy, and the pulse is slippery and rapid. Urinary protein (self-test at home): Morning (+), afternoon (-) ~ (+-).

Adjust the prescription: notopterygium, Yizhiren, ginkgo, peach kernel, safflower, Eupatorium, water safflower, salvia, polyporus, poria, silkworm, cicada slough, ganoderma lucidum, rhodiola.

The same as before. Since then, the prescription has been added and subtracted, the patient has no discomfort, the urine routine test continues to be negative, and the 24-hour urine protein quantification is within the normal range.

Recipe: (Salvia miltiorrhiza, Moutan bark, Radix Paeoniae Alba) nourishing qi and promoting blood circulation, At the same time, use Banlangen, cicada slough, and stiff silkworm to clear away the scorching heat evil. The kidney governs water, and damage to the kidney collaterals affects the function of the kidney, resulting in edema due to poor diuresis. The child was treated with hormone shock therapy, followed by regular oral administration of prednisone. Although there was no obvious hypercortisolism, it still had potential side effects on the patient’s growth and development.

Notopterygium: pungent, bitter, warm, belongs to the bladder and kidney channels. It has the effects of relieving the exterior and dispelling cold, expelling wind and dampness, and relieving pain. For anemofrigid cold, headache and strong neck, rheumatism arthralgia, shoulder and back pain. “Using notopterygium to dispel wind and expelling dampness is in line with the basic treatment idea of ​​”treating kidney disease from wind”.

Yizhiren is pungent, warm, and returns to the spleen and kidney meridians. It has the functions of warming the kidney, consolidating essence and reducing urination, warming the spleen, stopping diarrhea and capturing saliva. Using Yizhiren to invigorate kidney qi and replenish kidney essence can also help Treatment of kidney disease.

Note: The text involves all kinds of compatibility, prescriptions, Prescriptions, etc. must be used for reference and application under the guidance of TCM practitioners face-to-face, and do not try blindly! This article is only for professional TCM practitioners’ reference and study, and cannot be used as a prescription.！