"The Six Classics are all diseases," and "the Six Classics of Zhongjing are legislating for all diseases, not for typhoid fever and one disease." "In long-term clinical practice, in-depth research has been carried out on acute and chronic nephritis and pyelonephritis, and it is recognized that this kind of kidney disease is mostly related to external infection in the early stage, and often occurs or aggravates the disease due to external infection. Therefore, nephritis has an intrinsic relationship with external sense, which is very similar to the six meridian syndromes, and gradually formed a program for the legislative use of the six meridians for kidney diseases.
1. Sun sickness.
1.The Sun is proven.
Acute nephritis mostly starts after streptococcal infection 1 4 months, and patients after infection mostly present with fever, chills, headache, sore throat, low back pain, pulse floating, etc. Or known as nephritis, recovering from external evils, corresponding to internal and external, and recurring old diseases. This is caused by the invasion of the sun by external evils and the unfavorable meridian qi. Treat sweating and relieve the surface, and open the ghost door to facilitate internal dampness. Generally, the prescription of ephedra forsythia red adzuki bean soup is the general treatment. If the symptoms are more severe, it should be carefully identified as wind chill or wind heat, and those with wind chill should use ephedra plus shu soup or Ma Xing barley soup; For those who are hot and windy, you can choose to use Yuewen Jiashu soup or Ma Xing Shi Gantang or Yinqiao Sanhua cut.
1) Wind chill external attack type.
Symptoms include edema of the eyelids, waking up in the morning, or edema of both lower limbs, or even edema of the whole body, fever, severe chills, poor urination, irritation, retching, thin pulse, thin white moss, etc. It is advisable to dissipate the cold and relieve the surface, and promote the lungs and water. Add or subtract ephedra forsythia red adzuki bean soup.
Fang uses ephedra and cinnamon branches to warm the table, open the ghost door, and disperse the wind and cold; Almonds descend lung qi, unblock the upper source of water, one xuan and one fall, lung qi can be adjusted, the waterway is smooth, and the water can be dispersed; With Zhu Ling, Poria cocos light infiltration and dampness, combined with cinnamon branches to warm yang qi, bladder, break the waterway, so that the water moisture comes out from the bottom. Scattered and infiltrated, although the medicine is opposite, but each goes its own way, secretly opening the ghost door and cleaning the house. Not only does the evil be dispersed, but the water also has its own way out. A sweat disappears invisibly, and a urine is discharged outside. Forsythia and red adzuki beans, with their coldness, can not only prevent the temperature of Xinsan, avoid their heat, but also benefit their water and dampness, and kill many birds with one stone. Mulberry white skin opens the lungs, unblocks the waterways, and prevents Xin from dissipating yin. The combination of various medicines can play the role of dissolving the surface and dissipating evil, dehumidifying and improving water.
2) Wind heat type.
Symptoms include obvious edema, poor urination, fever and chills, cough, dry mouth, sore throat, red tongue, thin yellow tongue, and thin pulse. This is caused by the invasion of wind and heat, the loss of lungs, and the overflow of water and dampness. Treat when clearing heat and detoxifying, dampness and detoxification. Add or subtract from the soup with the scriptures.
The recipe uses ephedra to promote lung relief, with gypsum to clear the heat of the lungs and stomach, and turn the pungent temperature into pungent coolness, which is one of the major characteristics of Zhongjing's application. Ginger with skin, one can sweat and dissolve the surface, more can turn qi and water, with ephedra, also Xuan and disperse, so that the lung qi is released. Poria cocos and Atractylodes macrocephalus infiltrate water and dampness, and the medicinal properties are downward and inward; It is compatible with ginger and ephedra, and has its own meaning of opposite. With honeysuckle, forsythia, platycodon spicy and cool to dispel evil, detoxification and fire, and hemp, ginger of the pungent temperature, one cold and one warm, so that the heat is cleared without the disadvantages of hurting the yang. It is a taste of motherwort, clears heat and water, invigorates blood and dispels blood stasis, so that the three cokes accumulate and cleanse up, and the disease can go away.
For the above two types, if it is accompanied by signs such as sweating and bad wind, you can use astragalus decoction to strengthen the surface and dehumidify the water. If there is more sweat and the bad wind is worse, it can be used with a jade screen.
Acute urinary tract infection, especially acute pyelonephritis, in addition to urinary tract irritation symptoms such as frequent urination, urgency, and painful urination, is often accompanied by fever, chills, headache, or sore throat. In addition to the above methods, it should also be supplemented with heat-clearing and detoxification and damp-heat clearing products.
2.Sun Intestine Syndrome.
If acute nephritis is incurable after streptococcal infection, or is untreated or mistreated, after about 1 2 weeks, the above-mentioned sun is incomprehensible, or partially disappears, and then the face, eyelids and limbs are swollen, and urination is not good. Therefore, the presence or absence of edema in the early stage of kidney disease can be regarded as one of the important signs of the disease. At this time, it is advisable to promote the bladder, dilute the water and reduce swelling, and also relieve external evils. Fang with five Ling. If the water is more damp and the edema is obvious, you can use Wuling Sanhe Wupi to drink; The evil is still even worse, and the more the maid adds the technique of Tang and Wuling to disperse the cut.
Wet internal stop type.
This type is equivalent to a solar water storage certificate. Symptoms include edema of the eyelids and face, swelling of the lower limbs and sunken by the morning, and even high edema of the whole body, which is not conducive to urination, and fever and chills are not obvious, which is caused by the internal stagnation of water and gas, and the unfavorable gasification of the bladder. It is advisable to treat qi and water, and improve the bladder. Fang Yi Wu Ling San to add flavor.
Fang uses Zhu Ling, Poria cocos, and Atractylodes macrocephalus to strengthen the spleen and dampness, and reduce swelling with water; Diarrhea, large belly skin Tongli urine, the effect of the drug tends to make the water wet from the lower part and discharged; One of the cinnamon branches promotes the gasification of the bladder, switches the sharp tricks, and the other dissipates the warmth, opening the ghost door to disperse the evil; Combined with forsythia, the effect is outward and upward, which can be in the dispersion of evil spirits, and the more water vapor is emitted; Accompanied by white grass root, heat and diuretic, it can not only prevent cinnamon branches from warming and helping fire, but also can clear and relieve depression with forsythia, which is compatible with the opposite, and the medicinal effect is uniform. If there is obvious yin deficiency, you can add birth, ligustrum, pregnant oxknee, etc.; Those with kidney yang deficiency add aconite; For those with severe edema, use this recipe to drink and cut it.
If the disease goes deeper, or if the disease does not heal for a long time, the evil enters the lower coke, and becomes combined with the blood, and the bladder vaporizes and does not work. Symptoms include less abdominal distension and hardness, poor urination, swelling of the face and limbs, pan nausea and vomiting, irritability, pulse sinkiness, and dark purple tongue. When the treatment is to invigorate blood and dispel blood stasis, the main thing is to use peach kernel Chengqi soup to treat it.
Second, the period of Yangming's illness.
1.Yang Ming has been proven.
Acute nephritis or acute pyelonephritis is incomprehensible, inappropriate, and transmitted to Yangming. There are also people who are very hot, and at the beginning of suffering from nephritis or pyelonephritis, they do not go through the sun and go straight to the sun. Clinically, fever, thirst, yellow urine, edema of the face and limbs, pulse count, red tongue and little lichen. When the treatment of yin and heat and water, the white tiger soup and Zhu Ling soup are used as the main cuts.
2.Yang Ming Fu Evidence.
Acute nephritis or acute urinary tract infection, the external evil is incomprehensible, and it enters the intestines of Yang Ming. Or the stomach has lodging and food, and the intestines accumulate heat and dryness, forming Yangming Fu, or chronic nephritis for a long time, Yin and Jin are damaged, and a large number of Xinwen infiltrating products are misused, which hurts and helps heat, dissolves dryness and heat, and combines with gastrointestinal dregs to become Yangming Fu. Symptoms include abdominal distention, constipation, hot flashes in the afternoon, dry lips, red tongue, and yellow moss. Clinical observation shows that chronic nephritis, especially in the uremia stage, with the application of rhubarb-based formulas, the stool is smooth, and its kidney function can be improved. Therefore, for those who have not weakened their physique, as long as they see stool induration, they do not need to have typical symptoms such as hot flashes and delirium, they can be given, and the yang and bright dry heat stagnation will be removed, and the intestines will be unobstructed, so that the evil poison in the body will have the opportunity to drain out.
3. Lack of yang disease.
Patients with acute nephritis, if the body is deficient in righteous qi, they can directly commit Shaoyang as soon as they become ill. or chronic nephritis, nephrotic syndrome, chronic renal failure, especially chronic pyelonephritis, which is often caused by external evils or exertion. The course of this disease is long, the righteous qi is deficient, and even the righteous qi is weakened, and the external evil is most likely to be involved in the lack of yang, so that the good and evil are divided, the cardinal is unfavorable, and the gall is depressed. In addition to the characteristics of the disease, the clinical manifestations are characterized by upset, nausea, chest and flank bitterness, hehehe, lack of desire to eat, unfavorable urination, poor sweating, and easy to catch colds repeatedly. Therefore, the treatment is to reconcile Shaoyang, support the righteous and reach the evil, and use small chaihu soup or chailing soup to dissolve.
Fourth, the period of Taiyin disease.
Acute nephritis is untreated and mistreated, and it does not heal for a long time, and it is easy to develop into chronic nephritis. At this time, the condition may change from the three yang to the three yin, marking the in-depth development of evil qi. The lungs belong to the organs of Taiyin, which are the upper source of water and the main channel of water; The spleen is also too bright, centered on the coke, and the main transport is damp. Sick to Taiyin, lung and spleen qi deficiency, dampness and unlucky, often edema back-up; If the central qi sinks and there is no power to control it, the subtle leakage will cause a large amount of proteinuria. At the same time, it is also accompanied by fatigue, poor appetite, abdominal distension after eating, pale tongue with tooth marks, weak pulse and other symptoms. When the treatment is to nourish the spleen and lungs, the cinnamon branch ginseng decoction is tailored.
The recipe uses Codonopsis radix and Atractylodes macrocephalus to strengthen the spleen and invigorate qi, and Poria cocos to dispel dampness and evil. Astragalus can not only tonify the spleen, but also nourish the lungs. As soon as the qi of the lungs turns, the water is damp and disperses, the lung qi is proclaimed, and the water is spread everywhere. The cinnamon branch is yang and qi, and the poria cocos is good for the bladder, so that the dampness goes away from the urine. It is more suitable for tangerine peel, one hard and one hard, and it rises and lowers turbidity. The bitterness of the cinnamon branch can be opened and declared, and the temper can be lifted and dispersed and the ability to be lucky. The bitterness of tangerine peel can be reduced and discharged, and the stomach qi can be smoothed without the pain of bloating. The spleen rises and the stomach falls, the hub of the medium coke gas machine is flexible, and the square gas machine is smooth, and the problem of water and dampness is eliminated. You can also choose Lizhong soup, Shenling Baizhu powder, etc.
Oligo-yin period. 1) Less shade and cold.
All kinds of kidney diseases do not heal for a long time, further depleting the righteous qi, and can be passed on to people to reduce yin. At this stage of the disease, the kidney yang deficiency, the temperature has no power, and the face and limbs are edema due to the overflow of water; Kidney deficiency cannot hide delicate and subtle excretion, and urine protein does not disappear for a long time; If the kidney yang is insufficient, the body loses its warmth, and it is afraid of cold and cold; The waist is the home of the kidneys, and if the kidney is warm, the waist and knees will be sore, soft and cold. At the same time, poor urination or long urine and nocturia may also be seen. If the edema is mild and there is a manifestation of kidney yin deficiency, it can be cut with Jinkui Kidney Qi Pills. If the edema is severe, it is planned to use Zhenwu Tonga Chuanduan, mulberry parasitic, and mountain wood meat to remove ginger.
In front, the kidney qi pill warms the yang and turns the qi, and the yin and yang are supplemented, which has the meaning of "those who are good at supplementing the yang must seek yang in the yin". Start with the root cause. With Zhu Ling to dilute the dampness, dissipate water in the bottom, salvia invigorates blood stasis, and waterproof dampness and blood stagnation for a long time. In the rear, the specimen is treated, and the aconite warms the kidney and aphrodisiacs, and the kidney yang is vibrated and the gasification is self-recovering, and the front and back are closed, and the opening and closing are moderate. With Codonopsis, Atractylodes, Poria cocos to strengthen the spleen, water and dampness; Sichuan breaks, parasitism, strengthens kidney qi, dissolves blood stasis, and helps aconite to gasify; Yamagi meat nourishes the liver and kidneys, collects subtleties, and prevents protein loss; White peony tonifies the liver and latent yang, and the acid of the flesh of Heshan is able to collect yin and essence, which can not only prevent the medicine from hurting the yin, but also contain the floating yang. The whole party is hot and aphrodisiac without the disadvantages of hurting yin, and there is no worry about dissipating righteousness.
If chronic nephritis and nephrotic syndrome are deficient in kidney yang, compound external evils, and edema is aggravated, the syndrome is too little and two senses, and it is advisable to have ephedra aconite fine spicy decoction and Wuling San.
2) Less yin heat.
In addition to damaging kidney yang, many patients also have kidney yin deficiency as the main manifestation. The reason for this is that the body is deficient in yin, or over-taking dry and permeable products, especially the use of adrenocorticosteroids and immunosuppressants for a long time, can damage the true yin, thus stopping the internal water and gas, and the true yin is insufficient, becoming a sign of less yin and heat. Such patients have more edema, soreness in the waist and knees, five heart irritations, dry mouth and like to drink, tinnitus and deafness, red tongue and little lichen, and protein and red blood cells in the urine test. When the yin is good for water, it is advisable to treat Zhu Ling decoction and two to pills (nephritis II).
The original recipe of Zhu Ling soup is made of ejiao, and I often use ejiao to change it to the raw land, because the raw land can not only nourish yin, but also clear away heat, especially can cool blood and stop bleeding, which is more suitable for the pathogenesis of chronic nephritis. The prescription is Poria cocos, Zhu Ling, and Ze Yuan, which permeates and dampness; Use talc to clear heat and dampness, and clear the scorching dampness and heat; Erzhi pills nourish the liver and kidneys, add Huai ox knee, mountain meat, etc. to enhance the power of nourishment, nourish the kidney and yin to cure its roots. The whole prescription is diluted and moisturized, although the medicine is opposite, but its effect is unified, the tonic is scattered, the nourishment is infiltrated, the tonic is not sluggish, the yin is nourished but not damp, the diuretic does not hurt the yin, and the evidence of the water and heat is quite in harmony with the chronic nephritis yin deficiency and water stopping, and the evidence of water and heat are combined. It is worth mentioning that due to the application of hormones and immunosuppressants at this stage, it is more common for patients with this type, nephritis II, which is multi-effect.
Syncope period. In the later stage of kidney disease, in addition to renal insufficiency, it often affects the heart, blood vessels, gastrointestinal tract, nerves, blood, bones and **. Its disease is often seen in the virtual and real, the cold and heat are mixed, the pathogenesis is complex and changeable, and the disease has penetrated deep into the yin, and the prognosis is poor. In the later stage of chronic nephritis, many liver and kidney deficiencies, hyperactive liver yang, and internal movement of liver wind, blood pressure will continue to be high for a long time, and may even be accompanied by convulsions of the limbs. When flexibly treated on the basis of carefully distinguishing yin and yang, it can be appropriately added to soften and calm the liver and quench wind.
For uremia patients, due to the decay of the true yang, turbidity and toxin remain inside, affecting the spleen and stomach, causing vomiting. At this time, when the rhubarb aconite soup is added with flavor to retain the enema, you can also take the Zhenwu soup internally to warm the yang and relieve turbidity. As for the loss of yin deficiency, heat and poison, water stasis intertwined, stasis obstruction of the veins, the stool is black, or **, hemoptysis, etc., it should be cut with peach kernel Chengqi decoction and rhubarb aconite decoction, and add acacia flowers and three as appropriate.
Seventh, dry lotus grass and other products that clear heat and nourish yin, stop bleeding and dispel stasis.
In short, the pathogenesis is complex and changeable, and non-party and one-of-a-kind methods can run throughout. Clinical syndrome should be based on the specific situation, flexible syndrome differentiation, appropriate medication, can reverse the pathogenesis and promote its healing.
Using the theory of the six meridians to guide the clinical treatment of kidney disease, it should be noted that although the six meridian stages have a certain stage, kidney disease often forms a combination of diseases in clinical practice, and the prescription should be selected according to the evidence to respond to the pathogenesis.
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