Allergic Purpura Nephritis—Xiaoban Fushen Decoction
(composition): Smilax 30g, Atractylodes 20g, Achyranthes bidentata 15g, Phellodendron 10g, Phytolacca 15g, Fangji 10g , burdock seed 20g, pangolin 10g, roasted licorice 10g.
(Efficacy and Indications): Detoxification and dehumidification, clearing heat and promoting blood circulation. For allergic purpura nephritis.
(Prescription): On the basis of summarizing previous discussions, combined with years of clinical observation, verification and analysis, the proposed Divided into the key academic point of view of its pathogenesis. Reuse Xinliang detoxification and dampness-dispelling products, combined with blood-activating and collateral-dispelling agents, and add or subtract according to the symptoms, and the effect is quite good. Smilax smilax is sweet and bland in nature, and it returns to the liver and stomach meridians. Smilax smilax is the king, whichever has the effect of detoxification, dehumidification and heat, and sharpening joints; The function of removing dampness and clearing away heat is a ministerial drug; Burdock fruit is bitter and cold in nature, which has the function of detoxification; Fangji is pungent and cold in nature, and has the effect of dispelling dampness and diuresis, and the bitter cold is good at diuresis and swelling, assisting the monarch medicine to clear heat and blood, detoxify, and diuresis. Swelling, Arctium also has the effect of evacuating wind-heat, wind can overcome dampness, so it can strengthen the effect of dehumidification and heat. Damp toxin accumulates in the blood, so the medicines of promoting blood circulation and dredging collaterals, panshanlong and Achyranthes bidentata are added to promote blood circulation and remove dampness. Roasted licorice moderates the nature of the medicine and harmonizes the various medicines. All the medicines in the prescription are cold and cool products. Adding licorice makes “the cold medicine can relieve the cold”. All medicines are used in combination to detoxify and dehumidify, clear away heat and activate blood, and then all diseases can be eliminated.
(Certification): Female, 21 years old . He sought treatment for skin purpura on both lower extremities for 3 months and mild eyelid edema for 10 days. The skin purpura of both lower extremities occurred 3 months before the visit due to food allergy, but there was no abdominal pain or joint swelling and pain, and the purpura subsided after oral antiallergic drugs. One month later, purpura reappeared, and the antiallergic drugs were continued to be taken orally, but the effect was not obvious. Then, intravenous injections of dexamethasone injection, vitamin C injection, and calcium gluconate injection (common dosage) were given for a total of 5 days, and the purpura gradually decreased. . 10 days before the visit, the eyelids were mildly swollen in the morning and went to the hospital for diagnosis and treatment. Urine test: urine protein (++) occult blood (++++), high power microscope: 15-20 red blood cells, 2-3 white blood cells. So I went to the nephrology department for treatment. Symptoms at the time of consultation: dry mouth like cold drinks, yellow urine, red tongue, yellowish slightly greasy fur, stringy and slippery pulse.
Physical examination: normal blood pressure, mild eyelid swelling, double Scattered crimson spots on lower extremities. Laboratory tests: 24-hour urine protein quantification 1.78g/L, normal liver and kidney function, blood lipids, color Doppler ultrasound of both kidneys and blood vessels were normal, six hepatitis B examinations were normal. Western medicine diagnosis: allergic purpura nephritis. TCM syndrome differentiation is syndrome of accumulation of dampness and poison. Be treated with modified Xiaoban Fushen Decoction. After 1 week of follow-up consultation, the purpura basically subsided, and the symptoms of dry mouth were alleviated. After taking it for 4 weeks, the clinical symptoms were relieved, red tongue, yellow fur, stringy and slippery pulse. Check urine protein (+), occult blood (++), 5 to 8 red blood cells under high power microscope, 24-hour urine protein quantification 0.83g/L. Followed by Xiaoban Fushen Decoction to add or subtract according to the symptoms. Eight weeks later, he had urine protein (-), occult blood (++), and 2 to 3 red blood cells under a high-power microscope. The defender continued to take the medicine for 10 weeks, and the urine test was the same as before. After 12 weeks, the urine test was normal, and the drug was discontinued. Follow up a case by regular visits to 1 year without recurrence.
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