A Case Report of Nephrotic Syndrome Treated with Combined Chinese and Western Medicine

JIA Meng; WANG Yi

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A Case Report of Nephrotic Syndrome Treated with Combined Chinese and Western Medicine

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A Case Report of Nephrotic Syndrome Treated with Combined Chinese and Western Medicine
1.Department of Nephrology, Yueyang Hospital of Integrative Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
DOI：

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JIA Meng, WANG Yi. A Case Report of Nephrotic Syndrome Treated with Combined Chinese and Western Medicine[DB/OL].（2023-03-18）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35601812&Fpath=home&index=0
DOI：

JIA Meng, WANG Yi. A Case Report of Nephrotic Syndrome Treated with Combined Chinese and Western Medicine[DB/OL].（2023-03-18）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35601812&Fpath=home&index=0 DOI：

摘要

病史摘要,2,患者青年女性，无明显诱因下急性重度全身水肿，进行性加重，双下肢尤为明显，伴发明显胸闷、气促，夜间不能平卧，完善相关检查肾病综合征、急性肾功能不全指标诊断明确，入住肾内科排查病因、积极治疗。中医诊断　阴水病、脾肾阳虚证。西医诊断　肾病综合征、急性肾功能不全、系统性红斑狼疮、狼疮性肾炎（狼疮足细胞病）。干预措施　入院后予以卧床休息、低盐优质蛋白饮食，监测24小时出入量，药物予纠正低蛋白血症、利水消肿、控制尿酸及血压、抗感染、抗凝、保肝、调节钙磷代谢、调节血脂等对症治疗，临时血透6次减轻心脏负荷，肾脏穿刺明确病理原因，针对原发病系统性红斑狼疮大剂量激素冲击治疗、免疫支持治疗。入院全程结合中医药治疗，治拟温肾健脾、利水消肿，方以麻黄附子甘草汤合肾着汤合五苓散加减，重用大剂量黄芪固摄利水，水蛭活血化瘀，黑豆改善低蛋白血症，菟丝子滋补肾元。疗效转归　患者全身水肿较前明显好转，尿量增多，血肌酐恢复至正常水平。

Abstract

History Summary,　The patient is a young female with acute severe generalized edema without obvious causative factors, progressively worsening, especially in both lower limbs, accompanied by significant chest tightness and shortness of breath, unable to lie down at night. The patient's diagnosis of nephrotic syndrome and acute renal insufficiency indicators is clear after perfecting relevant tests. The patient was admitted to the nephrology department for investigation of the cause and active treatment.,Traditional Chinese medicine diagnosis,　Yin-water disease, spleen and kidney Yang deficiency.,Western medicine diagnosis,　Nephrotic syndrome, Acute renal insufficiency Systemic, lupus erythematosus, Lupus nephritis (lupus podocytosis).,Interventions,　After admission, bed rest, low-salt and high-quality protein diet, monitoring of 24 hour intake and output, symptomatic treatment including correction of hypoproteinemia, diuresis, control of uric acid and blood pressure, anti-infection, anticoagulation, hepatoprotection, regulation of calcium and phosphorus metabolism, regulation of blood lipids, etc., temporary hemodialysis for 6 times to reduce cardiac load, renal aspiration to clarify pathological causes, high-dose hormone shock therapy for the primary cause of SLE, and Immunosupportive treatment. The treatment was combined with Chinese medicine, treatment of warming kidney and spleen, diuresis detumescence, party with Mahuang Fuzi Gancaotang,Shenzhaotang combined with Wulinsan, reuse of large doses of Astragali Radix, Hirudo to blood circulation, Sojae Semen Nigrum to improve hypoproteinemia, Cuscutae Semen to nourish kidney.,Therapeutic regression,　The patient's generalized edema improved significantly, urine output increased, and blood creatinine returned to normal level.

关键词

中西医结合治疗肾病综合征狼疮性肾炎

Keywords

combination of traditional Chinese and Western medicinenephrotic syndromelupus nephritis

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