| Nephrotic Syndrome (NS) is very common in renal diseases of childhood. The incident rate is increased recently and caused the worldwide attention. Most of doctors believe that high permeability of glomerular filtration caused the proteinuria, and the proteinuria is related to the nephrotic edema. And it is many renal diseases that lead to nephrotic syndrome, moreover, in childhood most of them is primary nephrotic syndrome. With time going by, new and deep treads in studies on pathogenesis of nephrotic syndrome appear, but scholars still can't find the better therapy for the meatmen! The therapy of corticosteroid is the common prevention of nephrotic syndrome, and immunosuppressant is popular treatment with steroid-resistant nephrotic syndrome all around the world, doctors also developed some new medicine for the patients.According to the theory of TCM, the etiology and pathology of the disease is that nephrotic syndrome is developed by the external evils because of the usual basis and the deficiency of the lung, spleen and kidney. The main pathology is the unbalance of lung, spleen and kidney due to the stagnation of dampness. Based on the syndrome differentiation, the therapeutic principle may be warming of the kidney with strengthening spleen, or clearing of heat with discharging of damp. Furthermore, many physicians believe that the TCM combined with western medicine (WM) is a better therapy for the treatment of nephrotic syndrome, but how to elaborate the superiority of both TCM and WM so as to increased the curative effect and improve the life quality is an important topic worth of further study.Famous physician Song Guowei's experience on the treatment of nephrotic syndrome is original. He proposed that the treatment should aim at activating of blood circulation, and based on the activating, the therapeutic principle may be clearing heat, replenishing qi and promoting water flow. Satisfactory effect may be obtained by application of prescription and drugs according to different pathogenesis.The research mainly focus on the clinical effect of Song's theory for nephrotic syndrome through the experience on the clinic and laboratory and try to find out the mechanism of the childhood nephrotic syndrome.Under song's guide, the research is concluded by his five post-graduate students after 8 years, hi 1994,Xu Daji used the adriamycin(ADR)-induced nephropathy rats as the animal model, and he concluded that the hypercoagulable state is common in the nephropathy rats. And from the clinical research he also suggested that the doctors should regard thehypercoagulable state as the sign of "stagnation of blood", and should use the principle of removing blood in treatment all the time.In 1996, during experiment Liu Wenjie got the result that the herbs of activating blood circulation could induce the hypercoagulable state and reduce urine protein and serum cholesterol and increase serum albumin level.Zhang Wenping did both clinical study and experimental study in 1997, respectively, he got the conclusion that replenishing qi and promoting blood flow herbs could decrease the high blood viscosity of nephrotic syndrome and resist the damage of oxygen free radical.In 2000, after research Liang Hui proposed that the result of experiment showed that activating water and blood circulation decoction could improve indexes of blood rheology, reduce serum ET and lighten pathologic changes of kidney.2 years later, Zhou Yonghong investigated the correlation between angiotensin I converting enzyme(ACE) gene polymorphism and the treatment of clearing heat and activating blood in childhood nephrotic syndrome. The conclusion is that Genotype DD is associated with poor responsiveness to the therapy in NS children, respectively, Genotype II and Genotype ID is related to high responsiveness. And the treatment can reduce 24-hours urinary protein effectively,Finally, Song's theory is very valuable for the treatment of childhood nephrotic syndrome. So it is very important for every pediatrician to learn and de... |
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