The treatment of chronic nephritis includes the following aspects:
(1) General treatment: People with active chronic nephritis or obvious symptoms should rest and avoid colds, moisture, and overwork. , to prevent respiratory and urinary tract infections, and nephrotoxic drugs are prohibited. Protein intake should not be excessive and should be controlled at about 1 to 1.2 grams per day. People with edema and high blood pressure should limit water and salt. People with renal insufficiency should adopt a low-protein diet.
(2) Symptomatic treatment: including diuresis, swelling, blood pressure control, anticoagulation treatment, and infections should be actively treated, especially potential infections, including asymptomatic bacteriuria.
(3) Western medicine treatment: Choose treatment drugs according to different pathological types:
1) Mild mesangial proliferative nephritis (including IgA nephropathy), mild proteinuria Tripterygium wilfordii preparations can be used; for those with massive proteinuria and nephrotic syndrome as the main manifestations, glucocorticoids and cytotoxic drugs can be used.
2) For severe mesangial hyperplasia or membranoproliferative nephritis, hormones and cytotoxic drugs must be applied in stages according to blood pressure and renal function, and attention should be paid to anticoagulation and antihypertensive treatment.
3) The efficacy of steroids and cytotoxic drugs on membranous nephropathy is not good, but for patients with early-stage membranous nephropathy (stages I and II), intensive treatment with hormones and other drugs is still recommended. to delay the progression of renal function deterioration. Tripterygium wilfordii and angiotensin-converting enzyme inhibitors can be used in combination with anticoagulant therapy to reduce proteinuria in some patients. However, the course of hormone treatment should not be too long.
4) Focal segmental glomerulosclerosis has greatly different responses to hormones and cytotoxic drugs. Those with nephrotic syndrome and normal renal function can still use them as appropriate, which may be helpful. It is helpful to improve the condition and reduce proteinuria, but avoid taking the medicine for too long or abusing hormones. The purpose of treatment for this type of nephritis is to protect kidney function.
(4) Treatment with traditional Chinese medicine: Chronic nephritis is generally divided into Type II such as spleen tight qi deficiency, liver and kidney yin deficiency, qi and yin deficiency, and spleen and kidney yang deficiency. Corresponding syndrome differentiation treatment can be given respectively. No matter what type of nephritis it is, it is necessary to add traditional Chinese medicine to promote blood circulation and remove blood stasis. If necessary, add heat-clearing and detoxifying drugs as appropriate, which is beneficial to the treatment of the disease.
1. Dietary management of chronic nephritis
(1) There are no special restrictions on the diet of patients with chronic nephritis, and they can eat ordinary diet.
(2) People with obvious edema should control their salt intake and eat a low-salt or no-salt diet to avoid aggravating edema. The salt limit is generally around 3g/d.
(3) If the kidney function is good, the protein intake can be appropriately increased to make up for the protein lost in large amounts of proteinuria, but not too much. If kidney function has been mildly impaired, a high-quality, low-protein diet should be given. Patients with mild or moderate renal insufficiency, especially those with massive proteinuria, must limit protein to maintain a positive nitrogen balance. For patients with renal insufficiency, control protein intake, generally 30-40g/d, and mainly focus on high-quality protein, or supplement essential amino acids, such as Shenling, etc. If the renal function is normal and there is a large amount of proteinuria, the protein intake can be appropriately relaxed, but it should not be >1.0g/kg.d to avoid aggravating glomerular hyperfiltration and glomerulosclerosis.
(4) The diet of patients with hypertension mainly involves controlling salt intake and appropriately controlling water intake.
(5) If it is an acute attack, treat it according to the dietary principles of acute nephritis.
(6) However, patients of any type should eat more fresh vegetables rich in vitamins, and long-term consumption of foods with added preservatives that are harmful to the kidneys is taboo. Those with yin deficiency and heat should eat less spicy and stimulating foods, such as wine, chili peppers, etc. Those with yang deficiency and cold should avoid eating raw, cold, and iced foods, and eat less fatty and difficult-to-digest foods.
2． Dietary treatment recipes for chronic nephritis
(1) Recipe for eliminating edema:
Fresh human milk recipe: Take fresh human milk and take 300 ml each time, twice a day. This product can be used to treat proteinuria caused by acute and chronic nephritis in children when the combined traditional Chinese and Western medicine is not effective.
Carp and red bean porridge: one carp, 50 grams of red beans, and 100 grams of japonica rice flour. Boil the carp first to extract the juice, divide it into 2 portions and take it 2-3 times. It can strengthen the spleen and dilute water, and is suitable for people with spleen deficiency and edema.
Compound astragalus porridge (Yue Meizhong’s empirical formula): Take 30 grams each of raw astragalus and raw coix seed, 15 grams of adzuki beans, 9 grams of chicken gizzard powder, 2 kumquat cakes, and 50 grams of glutinous rice. First, boil raw astragalus in water, remove the residue, then add raw coix kernels and adzuki beans, cook for half an hour, then add chicken gizzard powder and glutinous rice, and cook into porridge. Take it in 2 times, chew 1 kumquat cake after eating. 1 dose daily. Efficacy: Tonify the spleen and kidneys, replenish qi and strengthen astringency. It is suitable for patients with chronic nephritis with kidney yang deficiency and kidney qi failure. It is not suitable for patients with kidney yin deficiency, thready pulse, and red tongue. This recipe is highly effective in treating edema in chronic nephritis and is also effective in eliminating protein. ’
Qiyu porridge and rice tea: 30 grams each of astragalus, corn silk, and glutinous rice root, and 25 grams of fried glutinous rice. Add water and boil for about 30 minutes, remove residue and extract juice, drink frequently instead of tea. This method has the effect of replenishing qi and diluting water.
White Poria porridge: 15 grams of white Poria powder, 100 grams of japonica rice, walnut powder, salt and a little MSG. First wash the japonica rice, put it into the pot with the poria, add enough water, bring it to a boil over high heat, then switch to a simmer, and then add MSG, salt, and walnut core powder. Take twice a day for morning and evening consumption. This prescription has the effect of strengthening the spleen and stomach and eliminating edema.
Plantago porridge: 15 grams of plantain and 100 grams of japonica rice. Wash them first to remove impurities, then put the japonica rice and plantain into the pot, bring to a boil over high heat, and then use Simmer until the rice turns into porridge. Take twice a day for breakfast and dinner. It has diuretic, swelling and neutralizing effects.
Adequate amount of 30 grams of mulberry seeds, 20 grams of raw coix seed, and 30 grams of raisins. Cook porridge and take it twice a day. It can nourish the kidneys and cure edema.
Put 30 grams of astragalus (wrapped in gauze), 30 grams of raw coix seed, and 7 red dates into water, boil until mashed, remove the astragalus, and then eat.
Carp Mother Soup: Take 1 fresh carp, remove the scales and internal organs, cut into sections, add 10 grams of motherwort and 3 slices of fresh ginger. Boil in water for 1 hour, remove residue, and decoct into 1200-1500 ml soup. Take about 200ml each time, 2 times a day.
Carp and winter melon soup: Take 1 live carp and 500 grams of winter melon. Cut open the fish, remove scales, wash, peel the winter melon, add water and stew. Drink soup and eat fish, 2 times a day. It has the functions of replenishing qi, activating blood circulation and diuresis.
Carp Yimu Decoction and Carp Winter Melon Decoction are used for Qi deficiency, blood stasis and water-dampness internal syndrome
(2) Protein elimination formula:
Astragalus and yam porridge: Take 50 grams each of raw astragalus, raw yam, and japonica rice. Boil the astragalus for 20 minutes, remove the residue and extract the juice, then add yam and japonica rice to cook into porridge, and take it warmly twice in the morning and evening. One dose per day for long-term use. This method is suitable for patients with chronic kidney inflammation who have edema, fatigue, sallow complexion, palpitations, shortness of breath, pale and fat tongue, white coating, slow or weak pulse. It should not be used by those with yin deficiency and excessive fire and exogenous fever.
Corn silk drink (Yue Meizhong's experience recipe): 60 grams of corn silk, add 600 ml of water, simmer for 20 minutes, replace tea, make a daily amount, no matter how many times. This recipe is suitable for children under 15 years old. If you take it for a long time, generally those without special circumstances will tend to get better or achieve cure
Gorgon fruit and ginkgo porridge. Take 30 grams of Gorgon fruit, 10 ginkgo fruits, and 30 grams of glutinous rice. Boil Into porridge. Once a day, 10 days constitutes a course of treatment (for those who eat less, 15 to 20 grams of glutinous rice and glutinous rice can be used). Efficacy: Strengthen the spleen and strengthen astringency. It is used for the syndrome of spleen failure.
Golden cherry porridge: 30 grams of golden cherry, 50 grams of japonica rice, and a little salt. After washing the golden cherry seeds, put them into a pot, add an appropriate amount of water, bring to a boil over high fire, then switch to slow fire and cook until the rice is rotten into porridge, add salt and mix well. It has the effect of benefiting the kidneys and strengthening essence.
Bian Que Three Beans Drink (Lu Zhizheng’s prescription) consists of one liter each of black soybeans, mung beans, adzuki beans, and two liang of licorice. Add eight liters of water to the above flavors and cook until thoroughly cooked. Eat beans and drink the soup as you like. Take it for a long time. It is suitable for patients with chronic nephritis and proteinuria that cannot be cured for a long time.
Walnut honey drink: 30 grams of honey, 10 walnut kernels. Add appropriate amount of water to walnut kernels, boil and fry for 15 minutes, then add honey. Can be taken for a long time. Mainly used to treat patients with chronic nephritis due to long-term spleen deficiency, weak kidney essence, pale complexion, mental fatigue, lack of appetite, and long-term proteinuria.
Turtle stewed with pork belly: 200 grams of turtle and 200 grams of pork belly, cut into small pieces, put in a casserole with appropriate amount of water, stew, add a little salt to adjust, take in the morning and evening. Suitable for those with deficient spleen and kidneys and weak qi and blood.
Fresh goat milk therapy: Take 500 to 1500 ml of fresh goat milk every day, boil it and take it in divided doses. When taking it, you can mix it with a small amount of sugar or honey. You should especially avoid salt when taking goat milk.
Sesame and walnut powder: Take 500 grams of black sesame seeds and 500 grams of walnut kernels, and grind them into fine powder. Take 20 grams each time with warm water, chew 7 jujubes after taking it, 3 times a day, and the medicine will be used for one course of treatment. Efficacy: Replenishing liver and kidney, replenishing essence and strengthening qi. Used for liver and kidney deficiency syndrome.
Peanut and broad bean soup: Take 120 grams of peanuts, 200 grams of broad beans, and 50 grams of brown sugar. Add 3 bowls of water to the pot and cook over low heat. When the water turns brown and turbid, you can take it. Add appropriate amount of brown sugar when taking it. Take 2 times a day. Efficacy: Replenishing qi, dehumidifying, and resolving turbidity. Suitable for patients with qi deficiency and dampness syndrome
Boil radish water: Cut the radish into small pieces and boil it with an appropriate amount of water (it is better to submerge the radish pieces). Take 1 small bowl of radish water once a day. Efficacy: Replenishing qi, dehumidifying, and resolving turbidity. Suitable for syndrome of qi deficiency and dampness and turbidity
(3) Recipe for treating hematuria:
Lotus seed powder porridge: remove the core of 50 grams of lotus seed meat, add an appropriate amount of rock sugar, mix it into a paste, and put it into boiling water In the morning, cook it into porridge and eat a small bowl before going to bed every night. It has the effect of nourishing the heart and kidneys, calming the nerves and fixing the body. It is used for patients with persistent hematuria, kidney deficiency and insomnia.
Shepherd's purse porridge: Wash and chop 250 grams of fresh shepherd's purse (or 90 grams of dried shepherd's purse), use 100 grams of japonica rice, and add water to cook the porridge.
Astragalus porridge: 30 grams of astragalus, 50 grams of japonica rice. Wash it clean, use the juice to boil the rice into porridge, and eat it on an empty stomach. It is used for hematuria due to spleen deficiency that cannot control the blood.
Maogen Plantain Drink: 50 grams each of Imperata Imperata and Plantain Seed, 30 grams of sugar. Decoction in water. Used for hematuria due to blood heat.
Drink the loofah; wash a section of old loofah, boil it in water, and drink it cool. It has the effect of cooling blood and stopping bleeding. It is suitable for hematuria caused by heat damage to blood collaterals. It is suitable for supplementing hemorrhage caused by evil heat.
Bamboo grass drink: 10 grams each of bamboo leaves and Imperata root, taken with a meal instead of tea, to treat hematuria.
(4)． Recipe for lowering blood pressure:
6 grams of black fungus and 30 grams of persimmons, boiled and eaten together.
Tremella soup, 6 grams of white fungus, add a little rock sugar, simmer over low heat and drink.
Dip the coated peanuts in rice vinegar for 48 hours and take them once in the morning and evening, 7 to 10 grams each time.
Reducing blood pressure tea; 9 grams of radish leaves, 15 grams of hawthorn, 6 grams of Schisandra chinensis, appropriate amount of rock sugar (obese people do not need to add sugar), brew with boiling water to replace the tea. Used for high blood pressure caused by excessive liver yang.
Take a small cup of fresh celery juice three times a day. This prescription has liver-calming, diuretic and sedative effects and can be used for chronic nephritis with excessive liver yang.