| Background: Chronic glomerulonepheitis is developed from different kinds of pathogeny and different types of glomerular diseases. Hematuria, proteinuria, edema and hypertension are its typical clinical manifestations. It develops slowly but continuously and steadily, it has a long course,which can eventually lead to chronic renal failure. By identifying the differences of its clinical symptoms, it can be attributed to TCM diseases, such as"edema","lumbago","consumption from"and"chronic kidney wind", etc. TCM practitioners have accumulated abundant experiences to treat this kind of disease, and they have made great success. Recently, medical circle has done lots of research on such area, and these researchers have cast light on it. Mr. Zhouying, as a deputy chief physician in Beijing hospital of TCM, has a deep and critical view of TCM, and accumulated abundant experience of complex diseases, such as diabetes disease, nephropathy, chronic bronchitis, urinary tract infection, glomerulonephritis, etc.Objective: Doctor zhouying has always been engaged in clinical work and clinical teaching of TCM after he has graduated from BUCM in 1982, and has made great success in medical work, teaching and research. He was once the editor of the second part of the book——whole view of Chinese characteristic remedy, chief member of the study of the strategy position of TCM——one of the programs of China science and technology department.Doctor zhouying has always been sparkpluging that TCM education should contain basic education and clinical education. The basic education provided by our college is the foundation of TCM practice, while clinical teaching offered by TCM doctors is the crucial key for the students to open the door of TCM. So, it's very important to learn from those TCM doctors who have abundant clinical experiences about the way and methods to determine the property and quantity of disease."zhenghou", as an important word of TCM, contains the patient's habitus, age, sex, onset time, onset area, the process of disease, the process and reaction of therapy, diets and causes of disease, etc. Thus, it's clearly that different patients of the same disease have different"zhengzhou", and different stages of the same patient have different"zhenghou", too. This article reveals doctor zhouying's view of CGN, and describes thoroughly his remedy for this disease. By doing this work, our TCM students can grasp the typical thoughts of TCM, and can draw inferences about other cases from it. Methods and results: This article includes two parts, the review and the clinical experiences of doctor Zhouying in treating chronic glomerulonepheitis.The first part is the review of the general situation of familiar pathogenesis in the clinic of nephrology. Etiology and pathogenesis are the core part of TCM. As long as the pathogenesis is found, the principle of treating can be established. Some doctors argue that"accumulation of dampness heat becomes toxin","heat stasis in the blood","stagnation of blood stasis","invasion of wind"and"invasion of medicine toxin"are the basic pathogenesis of this disease, and are the decisive factors for its breaking, developing and deterioration. Others argue that deficiency of spleen and kidney is the main cause of chronic glomerulonepheitis. Nowadays, most TCM doctors agree that the basic change of it are deficiency of"qi"and solidness of evil. The"disorder of lung, spleen, and kidney"and"deficiency of qi, blood, pith, ying and yang"are the main deficiency syndromes; while"extraneous wind","stagnation of water and dampness","stagnation of blood stasis","accumulation of dampness heat"and"heat becomes toxin"are the main excess syndromes of the patient.Firstly, the cognition of the characters of its pathogenesis: Doctor Zhou thinks that the main pathogenesis of CGN are deficiency of qi and solid of xie. The major problem of Zang-Fu consumption is deficiency of spleen and kidney, and the lung, qi, blood, yingyang and pith are also in low condition."Accumulation and recurrence of dampness heat","stagnation of dampness and blood stasis","hyperactivity of liver-qi"and"invasion of extraneous wind"are the main problems of pathogenic excess.Secondly, his thoughts on how to treat proteinuria: Proteinuria is hard to cure, because it's easy to relapse. Doctor Zhou thinks that there are at least four reasons for this phenomena, such as deficiency of kidney-yang, lack of kidney convergence, accumulation and recurrence of dampness heat, and high protein diet, which are not independent but interactional. So, we should apply respectively the treatments of warming kidney to produce Qi, tonifying kidney to arrest nocturnal emission, clearing heat and expelling damp, avoiding high protein diet.Thirdly, the analyzing of the unique Chinese traditional medicine he has been using in treating CGN: There are too much fat and protein in our bodies in contemporary times, our"qi"and"blood"are cumbered by them. Chronic patients suffer from the deficiency of"qi"as well as the solidness of"xie". So, Doctor Zhou always show his priority to those TCM which can help circulate"qi"and"blood". When we treat hematuria and proteinuria, which are the signs of leakage of pith, we should also pay attention to the circulation of"qi"and"blood". Generally speaking, the reversion of function always goes before that of structure. Hence, when the results of patient's test begin to take on normal, he should continue to treat to promote the healing of the structure.Fourthly, the analyzing of the basic prescriptions for CGN: By analyzing the characters of pathogenesis of CGN, doctor Zhou has established five types of prescription for it. For instance, the soup of reinforcing spleen, supplying the kidney essence and expelling dampness is suitable for deficiency of spleen and kidney, lack of pith, and accumulation of dampness heat. However, every type is interactional not isolated. Therefore, we should increase or decrease the prescription according to the pathogenesis of CGN.Conclusions: Deputy chief physician Zhouying, by applying the ideas of辨证论治, has succeed to use TCM to treat CGN. Many patients get better or this disease has been successfully controlled.Doctor Zhouying advocates that analyzing pathogenesis and distinguishing the quality of disease are the foundational step of treatment, while identifying the quality of medicine and the quantity of disease are the crucial key for improving curative effect. Though gathering and analyzing his cases, we can see his broad and deep knowledge of TCM as well as of science and technology. Though analyzing his experiences in treating CGN, we can grasp the typical thinking manner of TCM, and we can draw inferences about other cases from it. I believe that more and more TCM students will enter the palace of TCM by gathering and analyzing their teachers'successful cases. This will play an important role in reviving TCM and eminent Chinese culture. |
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