Discussion On Traditional Chinese Medicine Treatment Of Chronic Renal Failure Based On Shaw 's "Total Decompensation Of Chronic Renal Failure"

Chronic renal failure (CRF), been a terminal obstinate disease caused by various chronic kidney diseases, was a group of clinic syndrome, with renal sufficiency, metabolites retention, fluid and electrolyte imbalances, acid-base imbalance of, abnormal hormone production as the clinical manifestations. Patients with chronic renal failure will suffer from impairment of the functions of the kidney totally. There was no specific name summarized on CRF in traditional Chinese medicine. According to pathologic changes, clinic symptoms and prognosis, anuria and vomiting, retention of urine, edema and consumptive disease had deemed to chronic renal failure as names of traditional Chinese medicine. Chronic renal failure usually signifies an ominous prognosis. With the increasing development and perfection of medical technology, patients’condition of chronic renal failure will stabilize by hemodialysis and renal transplantation. However, there were some limitations like complex operation and expensive medical cost, which cause difficulties that there was no probability of carrying out in developing countries. So the study of non-dialysis therapy, including therapy with traditional Chinese medicine has been confirmed as the feasibility of selection for chronic renal failure in delaying the development of disease progress and protecting renal function of patients lost financial ability.In the history of the development of TCM nephropathy, there were two professors playing decisive role, professor Zou Yunxiang from Nanjing and professor Shi Zhengsheng from Beijing. The former who founded the first study group on researching kidney diseases provided by TCM, seen as the founder of nephrology of TCM, took the lead in treating kidney diseases by TCM. The issue of "TCM therapy on Nephrosis" authored by professor Zou has become the first domestic medical theory on kidney diseases monographs. The later by whom existing therapeutic principles and methods in TCM was founded, considered to being the initiator of system info on nephrology of TCM, elaborated basic academic problem on kidney diseases by this system info on nephrology of TCM, which all has introduced clinical experience of treating kidney diseases by TCM substantially. But it’s difficult to advance the curative effect again from here. Professor Xiao Xiangru thought that single method or pattern of syndrome cannot solve all the problems on kidney diseases by TCM. Patients needed comprehensive approach to be diagnosed and treated. This was the reason why professor Xiao founded the theory of’integrated functional compensation therapy for chronic renal failure’,’integrated functional compensation therapy for chronic renal failure’wasn’t limited and passive treatment based on syndrome differentiation on attaching importance to renal treating only, which not only promoted clinic curative effect on treating CRF by TCM but found a approach on non-dialysis therapy on CRF.This thesis chose Xiao Xiangru Treat Nephropathy, The Medical Discussion Given by Doctor Shi, Zou Yunxiang Treat Nephropathy, Nephrology and Chinese National Knowledge Infrastructure on three Professor’s experiences of diagnosing and treating CRF as research object. Search Method was that CRF was relation of inclusion with treatment by TCM. Search Strategy were that CRF was relation of inclusion with ’integrated functional compensation therapy for chronic renal failure’, and CRF was relation of inclusion with professor Xiao Xiangru(or professor Shi Zhensheng).The essence of thesis elaborated the ’integrated functional compensation therapy for chronic renal failure’. The exploratory study was mainly the thoughts for treating CRF by ’integrated functional compensation therapy for chronic renal failure’. The research method was mainly used to documental method to summary and arrange three professor’s experience on treating acute, chronic nephritis, CRF, and analyzing ’integrated functional compensation therapy for chronic renal failure’. The material’s handling based on adhering to original meanings, adding author’s opinions. The basic contents were described as follows:The first part introduced background and academic origin of ’integrated functional compensation therapy for chronic renal failure’.Although some patients with chronic renal diseases achieved spontaneous remission, renal function continued to deteriorate in others, which caused metabolites retention, fluid and electrolyte imbalances, acid-base imbalance, abnormal hormone production in patients. CRF caused functional deterioration on multiple organs by diverse and complex pathogenic factors, mechanism and clinic symptoms. Although there’s different incidence on CRF in different country, area and population, the morbidity and the mortality of CRF have been increasing as report goes. CRF have threaded humans healthy on a global scale. In the treatment of this disease, hem dialysis and kidney transplant as continuous renal replacement treatment could lead to severe adverse reactions, such as cardiovascular complications, which were the major causes of mortality in hem dialysis patients. Nondialytic treatment would be the first choices to treat CRF. There were lots of different recognitions on prevention and treatment to CRF by TCM’s doctors. However it’s difficult to advance the curative effect on CRF. Professor Xiao Xiangru thought that single method or pattern of syndrome could not solve all the problems on kidney diseases by TCM. This was the reason why Professor Xiao founded the theory of ’integrated functional compensation therapy for chronic renal failure’. It’s referred to concepts on wholism, preventive treatment of disease and Zang and Fu theory operated in diagnosing and treating CRF, and core ideal on whole body’s compensation by Zang-Fu function replacing single compensation. As a new treatment system,’integrated functional compensation therapy for chronic renal failure’not only attached importance to integrated treatment, but as a new view or method to improving the effect on treating CRF.The second part introduced’integrated functional compensation therapy for chronic renal failure’by elaborating the therapy’s basic theory, basic regularity, characteristics of syndrome differentiation, therapeutic principles and treatment according to syndrome differentiation founded by professor Xiao Xiangru. Professor Xiao claimed that decreasing and even loss of normal function of vital-Qi caused retention of damp pathogen, toxin translating from damp turbidity and existence in blood tier. To summarize pathogenesis, it included decrease or even loss of normal function of vital-qi, retention of damp pathogen, conversion of damp pathogen into turbid pathogen, conversion of turbid pathogen into toxin, and toxin invasion of blood system. A drop in Qi transformation was considered to asthenia in origin, and retention of water, damp turbidity and poison were deemed to asthenia in superficiality. As for therapy, both vital-qi deficiency and pathogen sufficiency should be considered. This part emphasized’integrated functional compensation therapy for chronic renal failure’ referred to concept of wholism, preventive treatment of disease and Zang and Fu theory operated in diagnosing and treating CRF. There’s difference in order of compensation that the spleen was the first to participate in the compensation, lung, liver, heart, finally, and in clinic symptoms, which could be aggravated by some weighting factors like further contraction of exogenous evil, overfatigue, excessive sexual life, external environment and renal toxicity drugs.The therapeutic principles of’integrated functional compensation therapy for chronic renal failure’included attaching importance to whole, regulation yin and yang(removing the excess, invigorating the deficiency), treating disease from the root(to treat from the root when the condition of the disease permit, to treat from the branch under urgent situation, to treat from the root and the branch at the same time), routine treatment and contrary treatment(heat treated with warm, cold treated with cold, obstruction treated with tonification, diarrhea treated with purgation), strengthening the healthy qi and eliminating pathogenic factors, thinking highly of treating spleen and stomach, three categories of etiological factors. Although therapeutic methods on CRF was protecting residual nephron and maintaining compensation of kidney in western medicine, kidney compensated limitedly. The holism of taking five ZANG-organs as the core and theory of zang fu organs were used to strengthen whole compensation when patients suffered from CRF, which could combine traditional Chinese medicine with western medicine and elaborate the theory on preventive treatment of disease.The third part introduced three cases on treating CRF by’integrated functional compensation therapy for chronic renal failure’founded by Professor Xiao Xingu. Patients in the cases have poor water metabolism for suffering from chronic nephritis so long. Water retention in lower energizer caused edema of lower extremity. Middle-jiao invaded by damp and hot evolved from water-dampness, which leaded to the disorder of the spleen and stomach. So patients suffered from gastrointestinal symptom, such as gasteremphraxis, nausea and anorexia. Nosogenesis of patients in these cases could be elaborated that asthenia in origin and asthenia in superficiality, exactly, be elaborate asthenia of both the spleen and kidney. According to ’integrated functional compensation therapy for chronic renal failure’, professor Xiao Xingu respectively applied Danggui Shaoyao powder, Pinelliae Decoction for Purging Stomach-Fire, Ginseng Qi Di Huang Decoction, Yinpu Xuanmaiganjie soup and Shengxian Decoction flexibly to treat three patients diagnosed CRF with decompensation with medical history of chronic nephritis, IgA nephropathy and diabetic nephropathy in three cases, which could recovering renal function by recovering water metabolism and separating clear and excreting turbid of the spleen, lung and liver of the organism. The objective of elaborating these cases was that linking theory with practice.The fourth part introduced the author’s personal opinions for treating chronic renal failure. The paper discussed the importance of coursing and dissipating wind evil, relieving convulsion and spasm and opening the inhibited lung-energy for preventing and treating chronic kidney disease, and strengthening the spleen and stomach throughout course of chronic renal failure. Author also linked Shanghanlun with therapeutic methods on chronic renal failure, comprehending the text thoroughly, and thinking that vomiting,having a fever and obstructed tri-jiao could be treated by adopting Xiao Chaihu Tang. When there’s disease progression of patients with CRF, lung’s compensation would work if spleen and stomach’s function were damaged for uremic toxins’ invading from body fluid and blood. According to ’integrated functional compensation theory for chronic renal failure’, lung was an importance component in body’s compensation for its dispersing and descending functions and the dredging and regulating water passage. Exogenous factors like upper respiratory or gastrointestinal contracting infection could aggravate chronic renal diseases. So the paper discussed the importance of opening the inhibited lung-energy for preventing and treating chronic kidney disease. There were some clinical symptoms such as indigestion, vomiting and having watery stools in uremia when patients couldn’t accept rational symptomatic treatment. According to Shanghanlun, imbalance of yin and yang and complicated and confused condition can be recognized by analysing and differentiating febrile diseases in accordance with the theory of six pairs of channels of jueyin disease. Vomiting was a proper case by reading Shanghanlun carefully over and over again to be treated by some articles of jueyin disease, which can widen train thought and edify somewhat to the doctors.