Professor Yang Li 's Theory And Clinical Experience Of Treating IgA Nephropathy From The Spleen And Stomach

Background:IgA nephropathy is a common primary glomerulonephritis, which is the main cause of patients suffering from kidney diseases leading to end-stage renal disease (ESRD). The clinical treatments for IgA nephropathy maily included anti-inflammation, controlling blood pressure and combining hormone with immunosuppressant. It would relieve the patients’symptoms, however, such problems as impaired liver function, adverse drug reactions and repeated condition would come out. TCM owned abundant experience in the treatment of IgA nephropathy, which also had an advantage in less impaired liver function, little side effect and controlling the illness in a stable stage. Presently, some TCM doctors usually considered the IgA nephropathy from the perspective of Kidney to differentiate the symptoms and signs and make a prescription, which was too single. IgA nephropathy had a close relationship with spleen and stomach, from the perspective of spleen and stomach to treat IgA nephropathy clinically do get a good result. We sorted out the related experience of professor Zhan Yongli from the perspective of spleen and stomach, discussing the treatment of IgA nephropathy from multiple perspective.Objective:Professor Zhan yongli is the urology department director of Guang’anmen Hospital,China Academy of Chinese Medical Sciences, who has over 20 years experience in clinical treatment of kidney diseases, taught by well-known traditional Chinese and western medicine expert Dai xiwen. Professor Zhan yongli dug into ancient monographs like Huangdi Neijing, Treatise on Cold Pathogenic Diseases and Synopsis of Golden Chamber. He was good at applying classical prescription and proved recipe to treat all kinds of kidney diseases, especially on the TCM treatment of chronic kidney diseases which he has a wealth of experience. Professor Zhan yongli achieved satisfactory curative effect by using combined therapy of Chinese and Western medicine on several diseases, such as chronic glomerular nephritis, nephrotic syndrome, lupus nephritis, hepatitis b-related nephritis, chronic renal failure, etc. We will summarize the theoretical recognition and treatment experience of professor Zhan to providie some reference for multiple perspectives of traditional Chinese medicine treatment.Method:This paper was divided into three parts, that is the literature review, theory research and experience summary. First of all, we explored the research progress of traditional Chinese medicine in the field of IgA nephropathy, reviewed the progress of modern medicine in the treatment of IgA nephropathy. Secondly, we discussed theory basis of modem medicine and TCM of treating IgA nephropathy from the perspective of spleen and stomach, the relationship between the symptoms of IgA nephropathy and the treatment from the perspective of spleen and stomach, and the syndrome differentiation of IgA nephropathy. The last, we collected professor Zhan’s theoretical and clinical experience, common classification and recipe cases. This article analyzed examples related to clinical medical record to summarize professor Zhan’s experience on treating IgA nephropathy from the perspective of spleen and stomach.Results:There were two theoretical experience in treating IgA nephropathy from the perspective of spleen and stomach. First, the TCM experience was that spleen and stomach was closely related to kidney, spleen and stomach is the root of acquired constitution and the source of qi and blood, while kidney is the root of congenital. The relation between spleen and stomach to kidney could be subdivided into the relation between spleen and kidney, and between stomach and kidney. Kidney stores essence, needing the spleen transformation for water and grain, while on the other hand, spleen governs qi and controls blood, which also needs the function of kidney yang to warm to sustain the spleen’s normal function. Stomach governs the transmission of water dregs, the disorder of stomach will lead to the dysfunction of spleen in transportation. Second, the western medicine experience was that IgA nepropathy was closely associated with immune system, and gastrointestinal mucosa also played an important role in the occurrence of IgAnephropathy.The clinical experience of treating IgA nephropathy from the perspective of spleen and stomach are:First, professor Zhan considered that it was crucial to prevent and cure the exogenous pathogenic factors such as wind, fire, heat, dampness, cold, and summer-heat; Second, professor Zhan divided IgA nephropathy into four patterns and four syndromes. The four patterns were Lung qi deficiency pattern, Qi and Yin deficiency pattern, Spleen and Kidney qi dificiency pattern and Yin asthenia generating intrinsic heat pattern. The four syndromes were exogenous wind-cold syndrome, exogenous wind-heat syndrome, dampness-heat in middle jiao syndrome and dampness-heat in lower energizer; Third, professor Zhan divided IgA nephropathy into two types by the treatment from the perspective of spleen and stomach, that is, Spleen and Kidney qi deficiency, which included Spleen deficiency and Dampness exuberance, loose stool, as well as spleen-deficiency edema. And dampness-heat in middle Jiao which included syndrome of interior dampness-heat and obstruction of cold and heat. Conclusion:First, TCM treating IgA nephropathy could be from multiple perspective. Second, treating IgA nephropathy from the perspective of spleen and stomach had abundant theoretical support. Third, professor Zhan got a good result in clinical treatment from the perspective of spleen and stomach.