Research On Treatment Of Refractory Nephrotic Syndrome With The Therapy Method Of Both Lung And Kidney Besides The Characteristic Of Therapy Pharmaceutical By Professor Zhou Zhongying

This essay, under the guidance of associate researcher Guo Lizhong,the tutor and researcher Jin Miaowen,carries out processing,induction andsummary of the academic thoughts, clinical experiences,curative effectand administration characteristics of the therapy method of both lungand kidney to treat refractory nephrotic syndrome with by Professor ZhouZhongying. Besides, the essay also uses medical theories of traditionalChinese medicine and western medicine to further discuss the pathogenicmechanism and therapeutic methods of kidney diseases, especiallyrefractory nephrotic syndrome.The whole essay is divided into five parts.PartⅠ: It systematically reviews the recognitions of documents oftraditional Chinese medicine of generations on the pathogenic mechanismof refractory nephrotic syndrome and the state of treatment of refractorynephrotic syndrome by modern traditional Chinese medicine.It holds theopinion that the research on pathogenic mechanism of refractorynephrotic syndrome at present is still on the stage of summary ofrecognitions of predecessors, self exploration and clinical verifications,and comparatively unanimous deep recognition is lacked in the treatmentmethods that have various types.This part further discusses the necessity of the recognition of traditional Chinese medicine on pathogenicmechanism of refractory nephrotic syndrome and exploration of effectivetherapeutic methods.on the time, it systematically reviews the statement,method and latest research progress on the aspects of pathogenic factors,pathology, pathogenesis and treatment of refractory nephrotic syndrome.PartⅡ: clinical researches.It is observed that comparatively soundclinical curative effects are obtained in 25 cases of primary nephroticsyndrome through differentiation treatment. We find in the observation ofstudied cases that most pathogenic factors of refractory nephroticsyndrome are combinations of deficiency and excess.The main parts ofexcess are as follows: damp, heat, blood stasis, phlegm, and toxin, withthe occurrence frequency of 92%, 88%, 52%, 44% and 32%respectively.The main symptoms are puffiness of the limbs, dizziness,headache, nausea,vomiting and soreness of the waist and knees,etc.Themain parts of deficiency are asthenia of both the lung and the kidney,accompanying by asthenia of both the spleen and the kidney and/orasthenia of both the liver and the kidney sometimes, with the frequencyof 92%.The main symptoms are darkish complexion, dizziness, headache,lassitude, cough with dyspnea, spontaneous perspiratio and fatigue, andsoreness of the waist and knees, etc.The symptoms of some patients arethe ones of deficiency of both yin and yang, most of which appear in theanaphase of refractory nephrotic syndrome chronic renal fail, peritontal dialysis and/or hemodialysis.The symptoms during the peritontal dialysisand hemodialysis are darkish complexion, intolerance to cold and coldlimbs, hypodynamia, lassitude and tastelessness, etc, with the totalfrequency of 92%. In consideration of the pathogenic characteristic, theincidental and the fundamental shall be treated at the same time. However,from the aspect of whole administration analysis, the elimination ofpathogenic factors shall be the main part (64%), with cure of deficiencyas the supplementation (30%). The mains components of the eliminationof pathogenic factors are as follows: to remove dampness and promotediuresis, to dissipate heat, to disperse blood stasis and dredge collateral,to regulate qi and reduce phlegm, and to eliminate toxin, with theproportions of 16.22%, 15.28%, 14.35%, 11.70% and 6.60% respectively.The main parts of cure of deficiency are as follows: to invigorate the lungand the kidney, and to nourish qi and yin, with the proportion of about23.39%. According to the pathologic factors of the disease, it is the bestmethod to eliminate damp and heat, resolve and reduce phlegm, removetoxin and restore qi.According to the clinical observation results, the main symptoms ofmost cases are obviously relieved, especially puffiness of the limbs andfatigue (p＜0.01), while the damages of kidney functions recoverslowly(p＜0.05). The whole living standard has improved, with theaverage increase of KPS of 10.83 cents and effective rate of 74%. The clinical remission rate (CR+PR) reaches 68%.PartⅢ: discussion on the therapy thoughts. The general principle isdifferentiation treatment, combination of symptoms, support of thenormal and tonification of the deficiency and elimination of pathogenicfactors and invigoration of the fundamental. However, detailed treatmentshall be made for distinctive pathologic features of the refractorynephrotic syndrome. The main parts of cure of deficiency are as follows:to invigorate the lung and the kidney, and to nourish qi and yin.The mainscomponents of the elimination of pathogenic factors are as follows: toremove dampness and promote diuresis, to dissipate heat, to disperseblood stasis and dredge collateral, to regulate qi and reduce phlegm, andto eliminate toxin. In this way, we can manage combination of symptomsand treatment of both the incidental and the fundamental.PartⅣ: typical cases. According to the disease types, we chosesome cases from the diagnosis cases by Professor Zhou Zhongying in theperiod from January 1 1990 to December 31 2005, as well as thefollowing clinical diagnosis procedure, and performed processing andanalysis, aiming at further explanation of the academic viewpoints ofProfessor Zhou Zhongying.PartⅤ: traditional Chinese herbs and Chinese traditional patentmedicine usually used for kidney diseases. This part introduces thetraditional Chinese herbs and Chinese traditional patent medicine usually used for kidney diseases and analyzes them one by one by combination ofrelated researches of modern pharmacology for reference.