| Close attention were given to the therapy of regulating spleen and stomach by physicians of generations. Being an important method of the treatment of chronic kidney disease, therapy of regulating spleen and stomach is widely used in clinic. Analyses from the theory of traditional Chinese medicine, the deficiency of both spleen and kidney and the syndrome of dampness-heat are two basic pathogenesis of proteinuria. What's more, the spleen deficiency together with dampness-heat is a kind of common clinical syndrome.Professor Yu Renhuan, who analyzed the formation and development of the theory of the spleen and stomach from Huang Di Nei Jing, Shang Han Za Bing Lun to Pi Wei Lun, put the priority of the treatment of proteinuria on regulating the spleen and stomach, with which positive curative effect can be achieved.This paper can be divided into three parts, including literature review, clinical study and analysis of knotty cases. And then, it expounds the experience of the application of regulating spleen and stomach on the treatment of proteinuria with chronic glomerulo. nephr i t i s.Origin of the spleen and stomach theory, application of regulating spleen and stomach in treatment of proteinuria, and recent progress of proteinuria in modern medicine is presented in the first part.In the second part, the major objective of the clinical study is to explore the effect of the therapy of regulating spleen and stomach on patients with proteinuria. During the period from December2010to April2012, we enrolled78patients with a diagnosis of primary glomerular diseases with proteinuria into this research, whose24-hour urine protein greater than0.5g and estimated glomerular filtration rate greater than60ml/(min·1.73m2) before treatment. And these patients were divided into two groups by their24-hour urine protein.Statistical analysis was performed with two groups of related non-parameters Wilcoxon symbols test to test the change of24-hour urine protein before and after treatment. Two-side test was used in test of statistical significance. The plasma albumin before and after treatment were analyzed with paired-t test. Differences were considered to be significant if P<0.05. Result:There were significantly different results in both24-hour urine protein and plasma albumin between before and after treatment (all shows:P<0.05). The complete cure rate of all the78patients was26.92%, the essential remission rate was19.23%, and the total effective rate was83.33%. The group of nephritis with24-hour urine protein greater than0.5g and less than3.5g had a remission rate of53.5%which contained both the complete cure rate and the essential remission rate, while the group of Nephrotic Syndrome with24-hour urine protein greater than3.5g had a remission rate of42.9%. The24-hour urine protein of the nephritis group decreased by52.6%while the Nephrotic Syndrome group decreased by65.1%.Conclusion:the traditional Chinese medicine method of regulating of spleen and stomach is an effective treatment on reducing proteinuria.Analysis of15knotty cases, described in the last part, demonstrate clinical experiences, characteristic of treatment and utilization of drugs based on syndrome differentiation.During the treatment, prescriptions of strengthening spleen and eliminating dampness were commonly used, such as Buzhong Yiqi decoction, Shengyang Sanhuo decoction, Shengyang Yiwei decoction, Fangji Huangqi decoction, Shenling Baizhu powder, base on which professor Yu created Jianpi Qushi Heluo decoction. |
PDF Full Text Request