Chronic nephritis mostly results from acute nephritis that is lingering without cure. The disease may have latent onset as well. It can develop into chronic renal failure eventually. Therefore, people should attach great importance to the rehabilitation at remission stage.
1. Syndrome differentiation and treatment
(1) Excessive dampness due to splenic asthenia
It manifests mild edema worsened after physical overstrain, mental fatigue, hypodynamia, anorexia, facial edema with yellowish complexion, reddish tongue with white and thin fur, deep and slow pulse. It is advisable to strengthen the spleen to promote diuresis. The prescription used is the modified Shenling Baizhu Powder (Power of Ginseng, Poria and Bighead Atractylodes). In the case of urinary protein, use more Huangqi (Radix Astragall seu Hedysari) and add Chixiaodou (Semen Phaseoli) and Chantui (Periostracum Cicadae). Click here to learn Chronic Nephritis in TCM.
(2) Asthenia of both the spleen and kidney
It manifests pale complexion, listlessness, lassitude, hypodynamia, aching pain of the waist, edema of lower limbs which does not restore to the original state when pressed, white and thin fur and thready pulse. It is advisable to strengthen the spleen and kidney. The prescription used is the modified Bupi Yishen Decoction (Spleen-Strengthening and Kidney-Benefiting Decoction).
(3) Yin deficiency of the spleen and kidney
It manifests dizziness, headache, dry eyes blurred vision, tinnitus, hyposomnia, red complexion dry throat and mouth, red tongue with a little fur and taut pulse. It is advisable to nourish the liver and kidney. The prescription used is the modified Qiju Dihuang Bolus (Bolus of Six Drugs, Rehmannia with Wolfberry and Chrysanthemum). In the case of hypertension, add Zhenzhumu (Concha Margaritifera Usta), Xixiancao (Herba Siegsbeckiae) and Juemingzi (Semen Cassiae); in the case of purple tongue, add Taoren (Semen Persicae), Honghua (Flos Carthami) and Danggui (Radix Angelicae Sinensis). Click here to learn Causes of Chronic Nephritis in TCM.
(4) Internal accumulation of dampness and heat
It manifests sticky mouth with bitter taste, vexation, or sore throat, epigastric oppression, anorexia, dry mouth with scanty water intake, yellowish and scanty or yellowish urine, red tongue with yellowish and greasy fur, slippery and rapid pulse. It is advisable to clear away heat and promote diuresis. The prescription used is the modified Ganlu Xiaodu Pill (Sweet Dew Detoxication Pill). In the case of scanty urine, add Zexie (Rhizoma Alismatis), Fuling (Poria) and Zhuling (Polyporus Umbellatus); in the case of sore throat, add Tuniuxi (Radix et Rhizoma Achyranthis), Xuanshen (Radix Scrophulariae) and Mabo (Lasiosphaera seu Calvatia) .
2. Rehabilitation methods
(1) Recreation therapy
It is advisable to appreciate music, calligraphy and painting, grow flowers, raise birds, go fishing and outing. As for the musical therapy, in the case of low spirits, select the musical prescriptions of "inspiring the enthusiasm and arousing the feeling"; in the case of dysphoria, select the prescriptions of "tranquilizing the mind"; in the case of edema, appreciate the natural sounds like flowing water and peaceful and happy music. Click here to learn Symptoms of Chronic Nephritis in TCM.
(2) Physical training
It is suitable to take a walk on the flat ground for fifteen to twenty minutes in the morning or at dusk. In addition, it is advisable to select Taijiquan, five mimic-animal games and eight-section brocade.
(3) Acumox and massage
Acumox: Select Shenshu (BL 23), Pishu (BL 20) and Sanjiaoshu (BL 22). In the case of splenic asthenia, add Shuifen (CV 9), Qihai (CV 6), Zusanli (ST 36) and Sanyinjiao (SP 6); in the case of renal asthenia, add Mingmen (GV 4), Pangguangshu (BL 28), Guanyuan (CV 4) and Yingu (KI 10). Apply acupuncture once every other day. Mter acupuncture, apply moxibustion, or moxibustion with the warming needle.
Acupoint injection: Inject 2 ml of Bannangen (Radix Isatidis) injection and 2 ml Yuxingcao (Herba Houttuyniae) injection into Shenshu (BL 23) (bilateral) and Zusanli (ST 36) (bilateral) alternately once a day and 20 times constitute one course of treatment. Or inject 0.5 ml of 5 % Danggui (Radix Angelicae Sinensis) injection into one to two acupoints of Jingmen (GB 25), Pangguangshu (BL 28), Shuidao (ST 28), Zusanli (ST 36) and Fuliu (KI 7) once a day and seven to ten times make up one course of treatment. Click here to learn TCM Diagnosis for Chronic Nephritis.
As for the ear acupuncture, select Shenqu and Pangguang (MA-SL 8), with the puncturing method, or the needle-embedding method of thumb-tack needle. It is also advisable to apply Wangbuliuxingzi (Semen Vaccariae) on acupoints externally.
Massage: Select the acupoints in the light of acupoint selection and adopt the pushing, kneading, pressing and scrubbing manipulations to massage the acupoints several times a day. It is also advisable to rub the costal regions, Shenshu (BL 23), sulcus auriculae posterior and Yongquan (KI 1) respectively for one hundred times or so with the palm in the morning and evening. In the case of hypertension, scrub and knead Yongquan (KI 1) or Taixi (KI 3) respectively for one hundred times in the morning and evening every day; in the case of nausea and vomiting, press and knead Zusanli (ST 36) and Neiguan (PC 6); in the case of scanty urine or anuria, press and knead Guanyuan (CV 4) and Sanyinjiao (SP 6) to dredge the water passage. Click here to learn Chinese medicine Treatment for Chronic Nephritis.
(4) Dietary therapy
In the case of excessive dampness due to splenic asthenia, select Spleen-Benefiting Cake, Gruel of Baibiandou (Semen Dolichoris Album), Eight-Treasure Gruel and Gruel of Huaishanyao (Rhizoma Dioscoreae); in the case of splenorenal asthenia, select Gruel of Lizi (Semen Castaneae), Soup of Dongchongxiacao (Cordyceps) and Gruel of Powder of Qianshi (Semen Euryales); in the case of hepatorenal yin deficiency, select Gruel of Shengdihuang (Radix Rehmanniae) and Paste of Tianmendong (Radix Asparagi). Click here to learn TCM Treatment Evaluation for Chronic Nephritis.
In the case of internal accumulation of dampness and heat, select Gruel of Huoxiang (Herba Agastachis), Gruel of Yiyiren (Semen Coicis) and Gruel of Pibaye (Folium Eriobotryae). Besides, it is advisable to select Gruel of Mahetao (Rhizoma Gastrodiae and Semen Juglandis) and Steamed Crucian Carp with Tea.
Drinking fresh goat's milk on an empty stomach every early morning is extremely beneficial to the treatment of the disease. Each time, cook 250 to 1,500 ml of goat's milk until it boils and take it in two different times by adding a bit of white sugar or honey. Abstain from salt during the milk-drinking period. Drink the milk continuously for one month. Supplement high-quality protein in the daily diet such as egg, fresh fish, duck meat, lean pork. As for fats, it is suitable to eat vegetable oil.
Eat green grams, red beans, wax gourds, watermelons, carrots, rapes and kelps at ordinary times. Abstain from sea-foods, allergenic products, pungent, fat and greasy foods like beef, mutton, dog meat, chicken meat, fresh jellyfish and shrimp. Control salt intake and abstain from salt in the case of edema. Do not overeat sugar so as to prevent renal diabetes. If the disease develops into renal insufficiency, it is advisable to select the diet with the low phosphorus and low protein.
(5) Nursing in daily life
Prevent common cold or other infectious diseases of respiratory tract strictly. Keep the oral cavity and skin clean at ordinary times. Moderate sexual life so as to prevent impairment of renal qi. Be sure to use drugs with caution to prevent renal injury due to drug toxicity. Drugs that harm the kidney should be absolutely contraindicated such as kanamycin, gentamycin and some antipyretic and analgesic tablets.