Summary And Reseach Of Professor Liu Bao-hou’s Academic Viewpiont And Clinical Experence Treating Renal Proteinuria In The Aspect Of Dampress And Heat

Professor Liu Bao-hou is a national well-known Traditional Chinese Medicine doctor and a mentor of the academic experience inheritance project authorized by Ministry of Human Resources and Social Security of the People’s Republic of China, National Health and Family Planning Commission of the People’s Republic of China and State Administration of Traditional Chinese Medicine of the People’s Republic of China. Spending 60 years in the clinics, teaching and scientific research of Chinese and Western Medicine, including 40 years in the kidney diseases, he is now a national well-known expert of integrative medicine and kidney diseases. This article reviews the progress of Chinese medicine treating renal proteinuria and henoch-schonlein purpura nephritis, summarizes Professor Liu Bao-hou’s experience treating renal proteinuria in the aspect of dampness and heat and analyses the clinical effect of clearing heat and supplementing kidney capsule guided by the academic idea ’eliminating proteinuria by clearing dampness and heat’through a prospective random controlled trial.Part 1 Literature reviewProgress review of Chinese medicine treating renal proteinuria showed that the consensus of Chinese Medicine about the mechanism of proteinuria is root deficiency and branch excess. Root deficiency refers to the deficiency of the lung, spleen and kidney while the branch excess refers to pathogens like coldness, wetness, heat and stasis. Kidney’s failure of storing essence renal causes proteinuria. In the treatment aspect, most of the doctors start from the general pattern differentiation and treatment before the adjustment of deficiency and excess. Supplementing spleen and kidney is mainly adopted while the methods of dispelling wind, clearing heat, removing dampness and resolving stasis are selectively chosen. The effects are guaranteed by the basic principle of "dispelling pathogens on the basis of reinforcing the healthy qi, enriching the deficiency while preventing obstructions and stasis"Henoch-schonlein purpura nephritis (purpura nephritis), the severest complication of allergic purpura, usually manifesting as hematuria and proteinuria, has the pathological features of prolonging and resurrecting. The prognosis of the disease is closely related to the damage of the kidney. The western medicine etiology of the disease is still unclear, but is considered to be related with the infections and allergic reaction. In the Chinese Medicine aspect, the mechanism of purpura nephritis is root deficiency and branch excess. Root deficiency refers to the deficiency of the lung, spleen and kidney while the branch excess refers to pathogens like wind-heat, wetness-toxin and blood stasis. There’re no effective treatments in the western medicine, while Chinese Medicine has showed remarkable effects in the controlling of purpura, hematuria, proteinuria, and improving of the patients’ allergic constitutions. The most effective treating principles are clearing heat, removing toxin, eliminating dampness and activating blood, resolving stasis and dredging collateral. Besides the fundamental principle of pattern differentiation and treatment, it is important to identify the stage of the disease. The main manifestation in the acute stage is the purpura and kidney damage in the chronic stage. The basic treatment principle should be ’enriching the healthy qi while expelling pathogens, dispelling pathogens on the basis of reinforcing the healthy qi’.Part 2 Summary of well-known old Chinese Medicine doctor Professor Liu Bao-hou’s academic viewpointBasing on decades of experience in the clinic, teaching and scientific researches, national well-known old Chinese Medicine doctor Professor Liu Bao-hou brought out many unique academic viewpoints. Encouraging innovations himself. Professor Liu Bao-hou drew up the ’Chinese Medicine pattern differentiation project of chronic glomerulonephritis’, which was adopted as the national tentative scheme in the second national congress of Chinese Medicine treating kidney diseases hold in Nanjing in 1985. The project was later included into the<Guideline of clinical researches about new Chinese Medicine> by the Administry of Health of People’s Republic of China, and guided the national diagnosis and treatment of chronic nephritis. For the first time in the country, he took the hemorheology test into the diagnosis, Chinese Medicine pattern differentiation and effect evaluation of the blood stasis pattern of glomerular diseases, which offered an easy objective parameter for the diagnosis of the blood stasis pattern of glomerular diseases, and his articles were widely cited across the country. To summarize the correlation between the lung and kidney, he invented the concept of’lung and kidney correlation theory’, aiming to supply some theoretical evidence for the supplementing kidney method treating lung system diseases, such as chronic obstructive pulmonary disease. He also initiates the pattern and stage differentiation before treatment, namely’treating the same disease with different methods’. Another preventative example of his academic viewpoints is the usage of integrative method treating nephrotic syndrome.He brought out the principle of’integration of Chinese Medicine and Western Medicine for both diagnosis and drugs’, and emphasized the importance of locating the "integrative point’. Basing on the overall analysis of the etiology and mechanism of kidney diseases and abundant clinical practices, Professor Liu Bao-hou presented three keys treating kidney diseases with Chinese Medicine:dispelling the pathogens till the end and reinforcing the healthy qi moderately; eliminating dampness and heat completely to cease proteinuria; dispelling stasis for the recovery of kidney qi. About sanjiao, Professor Liu Bao-hou thinks that it’s not a material organ, but three regions of the body divided by the ancient people. Qi transformation theory generalized the functions of the organs and sanjiao is just a theory about qi transformation. He also sings highly of the idea ’the key of pattern differentiation is referring to both location and nature of the disease’, which supplies a fundamental outline for the primary Chinese Medicine students.Part 3 Summary of Professor Liu Bao-hou’s clinical experience treating renal proteinuria in the aspect of dampness and heat"Kidney’plays an important role in the zang-fu organ theory of Chinese Medicine. It doesn’t only refer to the anatomical kidney organ, but also an important organ extensively related to the reproduction, growing development, water metabolism, and neurology and endocrinology metabolism. It has the power to govern the life that doctors of many generations called kidney as ’root of congenital constitution’ and ’root of life’. The reason of the formation of wetness and heat is complicated. Professor Liu Bao-hou pointed out that dampness and heat mainly derived from the following two aspects:external and internal dampness combining together to generate heat; long-time intake of hormones inhibiting the original yin and yang which causes disharmony of yin and yang and internal production of dampness and heat. As the fundamental feature of kidney diseases, dampness-heat damaging kidney exists through the course of the disease. The dampness-heat pathogen is prone to retaining inside the body, damaging healthy qi and eliciting external invasion. Infection is the main reason of the degeneration of the disease.According to the understanding of Traditional Chinese Medicine, proteinuria is caused by failure of storing essence and insecurity of kidney, and the main mechanism is root deficiency and branch excess. Professor Liu Bao-hou pointed out that the most common excess pathogen causing continuous proteinuria is dampness and heat.In the’eliminating dampness and heat completely to cease proteinuria’viewpoint, Professor Liu Bao-hou concluded that if there were infections in the patient, there were various manifestations of dampness and heat pattern. Professor Liu Bao-hou eliminated dampness and heat according to the sanjiao theory. For the upper jiao dampness and heat, an experienced formula clearing heat and supplementing kidney decoction was used. For the middle jiao dampness and heat, modified Bupleurum Liver-Soothing Powder and Three Kernels Decoction were adopted to ventilate qi activities, dry dampness and excrete water. For lower jiao dampness and heat, modified experienced formula relieving stranguria and supplementing kidney decoction was used. Early using of replenishing qi and nourishing yin method would lead to retaining of dampness-heat and proteinuria, which reflects the importance of eliminating dampness and heat in the treatment of chronic kidney diseases, and approves the’eliminating dampness and heat completely to cease proteinuria’ viewpoint.Part 4 Clinical observation of the effects of professor Liu Bao-hou’s experienced formula clearing heat and supplementing kidney decoction treating proteinuria in purpura nephritis patientsObjective:To observe the effects of clearing heat and supplementing kidney decoction treating proteinuria in purpura nephritis patients. Methods:Randomly divide 60 purpura nephritis patients of dampness-heat and blood stasis pattern into two groups,30 cases in each group. Regular western medicine treatments were given to patients of both groups. Besides the regular treatments, patients in the treatment group were given clearing heat and supplementing kidney decoction. The changes of the parameters of total 24hour urine protein; Chinese Medicine pattern score, urine protein and turning negative rate of urine protein were recorded in both groups for clinical effect analysis. Result:The effects of urine protein and Chinese Medicine pattern score and turning negative rate of urine protein in the treatment group showed statistically improvement than the control group (P<0.01). The total 24hour urine protein reduction in the treatment group is statistically better than the control group (P<0.05). Conclusion:The clearing heat and supplementing kidney decoction is effective treating proteinuria in purpura nephritis patients, which is worth further popularization in the clinic.